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horseshoe kidney : ウィキペディア英語版
horseshoe kidney

Horseshoe kidney, also known as ''ren arcuatus'' (in Latin), renal fusion or super kidney, is a congenital disorder affecting about 1 in 500 people, more common in men.
In this disorder, the patient's kidneys fuse together to form a horseshoe-shape during development in the womb. The fused part is the isthmus of the horseshoe kidney.
Fusion abnormalities of the kidney can be categorized into two groups: horseshoe kidney and crossed fused ectopia. The 'horseshoe kidney' is the most common renal fusion anomaly.
==Presentation==

In patients with this condition, the central portion of the kidney may be found just inferior to the inferior mesenteric artery because the normal embryologic ascent of the kidneys is arrested by its presence in people with central fusion of the kidneys. Horseshoe kidney is often asymptomatic, though persons affected by this condition may experience nausea, abdominal discomfort, kidney stones and urinary tract infections at greater frequency than those without renal fusion. There is currently no treatment for renal fusion other than symptomatic treatment.
Imaging Findings -
The 2 kidneys on opposite sides of the body with the lower poles fused in midline. Midline or symmetrical fusion (90% of cases).
May be missed on US, therefore pay careful attention to identification of lower poles of kidneys.
Renal long axis medially orientated,
Lower poles with curved configuration, elongation and poorly defined
Isthmus crosses midline anterior to spine and great vessels.
US for diagnosis in utero
IVP followed by CT or scintigraphy for pre-operative assessment
Variant arterial supply -
Bilateral renal arteries,
Inferior mesenteric Artery,
Arteries arising from aorta or common iliac, internal iliac, external iliac or inferior mesenteric arteries.
The lower poles of these kidneys fuse in the midline anterior to the aorta and spine. The isthmus is usually located at L4/5 level between the aorta and IMA.
Nuclear medicine (DMSA) scan confirms horseshoe kidney with fusion of both renal lower poles.

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
ウィキペディアで「horseshoe kidney」の詳細全文を読む



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