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PUJ in Horse Shoe Kidney

PUJ in Horse Shoe Kidney. Harsha, Vineeth P. Soundararajan, S. Ramesh Babu Dept of Radiology, Nephrology & Paediatric Urology Sri Ramachandra Medical College Sri Ramachandra University. History. 10 yr old boy Presented with h/o right loin pain 2 wk Vomiting ,Dysuria, No fever

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PUJ in Horse Shoe Kidney

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  1. PUJ in Horse Shoe Kidney Harsha, Vineeth P. Soundararajan, S. Ramesh Babu Dept of Radiology, Nephrology & Paediatric Urology Sri Ramachandra Medical College Sri Ramachandra University

  2. History • 10 yr old boy • Presented with h/o right loin pain 2 wk • Vomiting ,Dysuria, No fever • Past h/o UTIs present • Evaluated for renal problems earlier with USG • Found to have horse shoe kidney earlier

  3. Evaluation • Hb 12.4; TC 10300; • P81, L18, E1, Plt 1.51 • BUN 14, Cr 0.6, • Na 138, K 4.3, Cl 104, HCo3 21 • Urine R/E 2-3 PC, Protein: nil • Urine C&S: no growth

  4. Ultrasonogram

  5. DTPA Scan

  6. DTPA scan

  7. CT Scan

  8. CT reconstruction

  9. CT help to plan laparoscopy

  10. Cystoscopy & RGP

  11. Laparoscopy port positions 30o rt side up 5 Head Foot 10 5 10

  12. Horse Shoe Kidney • Most common of all renal fusion anomalies • Two distinct renal masses lying vertically on either side of the midline • Connected at lower poles by a solid or fibrous isthmus that crosses the midplane of the body • Horseshoe kidney occurs in 0.25% of the population, or about 1 in 400 persons • More common in males 2:1

  13. Horse Shoe Kidney • 1/3 remain asymptomatic • When symptoms present: related to calculus hydronephrosis, or infection. • UPJ obstruction causing significant hydronephrosis occurs in 1/3 • Imaging like CT or RGP often required • Treatment depends on the problem

  14. The End

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