Treatment for right-sided intrathoracic kidney with congenital diaphragmatic hernia by combined thoracoscopic and laparoscopic approach: a case report and literature review

BackgroundIntrathoracic kidney (ITK) associated with congenital diaphragmatic hernia (CDH) is rare congenital anomaly and usually requires surgery. The surgical methods and approaches are diverse.Case presentationWe reported a case of a 5-year-old boy who was diagnosed as right-sided ITK with CDH. Surgical treatment was performed by combined thoracoscopic and laparoscopic approach. Anatomical reposition of the right kidney and nephropexy were carried out under laparoscopy, and repair of the hernia was performed under thoracoscopy. The postoperative recovery was uneventful and long-term follow-up demonstrated normal function and development of the kidney.ConclusionCombined thoracoscopic and laparoscopic approach is minimally invasive and effective for treatment of ITK associated with CDH. It provides better visualization of the diaphragmatic foramen and the hernia sac, and can achieve anatomical reposition and fixation of the ectopic kidney.

Intrathoracic Renal Ectopia: A Case Report and Review of the Literature

: Renal ectopy is a rare phenomenon, which its diagnosis may be delayed due to an asymptomatic condition. The ectopic kidney may even have a normal functional state; however, because of occurring kidney blockade, the risk for kidney stones and even failure may be raised. In many cases, the diagnosis is completely incidental and is based on the request of radiography and sometimes, CT scan even for other reasons. In the therapeutic approach, in cases of kidney blockage, or urine backing up to the kidney, the surgical intervention is highly recommended by excisional removing the mass. Herein, we described a case of ectopic intrathoracic kidney initially presented with mild respiratory distress that was ultimately diagnosed by CT scanning and removed surgically.