López-Trapero IA, García-Rodríguez MA, Aragón-Tovar AR, Navarrete-García E

Language: Spanish
References: 10
Page: 108-112
PDF size: 417.16 Kb.

ABSTRACT

Congenital anomalies of the urinary tract are diverse and they include the total absence of the kidney, its location, orientation, or aberrant shape, as well as collecting system and blood irrigation alterations.
We present the case of a 2-month old male infant with symptoms of progressive abdominal distension and fever secondary to spontaneous kidney rupture. A renal and pyelic fusion with a single system associated with ureterovesical junction stricture was identified. Diversion was carried out by means of nephrostomy, after which Politano ureteral reimplantation and Hendren ureteral refashioning were performed. We also present a literature review.
In 1938 Wilmer first classified anomalies presenting with renal fusion, and then in 1957 McDonald and McClellan improved and broadened that classification to include crossed ectopia with fusion, crossed ectopia without fusion, solitary crossed ectopia, and bilaterally crossed ectopia. Anomalies with fusion can be 1) unilateral fused kidney with inferior ectopia, 2) sigmoid or S-shaped kidney, 3) lump or “cake” kidney, 4) L-shaped or tandem kidney 5) disc or shield kidney, and 6) unilateral fused kidney with superior ectopia. Our case did not fall into any of these classifications due to the presence of a single excretory system associated with obstructive megaureter secondary to ureterovesical junction stricture.
Only five cases of renal and pyelic fusion with a single ureter have been reported in the literature. Up to now, the present case is the only one associated with spontaneous kidney rupture in a pediatric patient that has been reported.

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