Lesson 4A (Part 3) Flashcards
What are 3 anomalies related to ascent of kidney?
- Ectopia
- Crossed renal ectopia
- Horseshoe kidney
Ectopia pelvic kidney
Failure of the kidney to ascend during embryology
Where is the ectopia pelvic kidney located?
In iliac region with malrotation of collecting system
What percentage have a decreased function with ectopia pelvic kidney?
50%
What happens to the ureters with ectopia pelvic kidney?
They are short
What do short ureters lead to?
Poor drainage
What does collecting system dilation lead to? (2)
- Infection
2. Stone formation
Where are the kidneys in a crossed renal ectopia?
Both kidneys are found on the same side
- may be fused to the other kidney
Crossed renal ectopia
Upper pole of the ectopic kidney will be fused to lower pole of the other kidney
Where are the ureterovesicular junctions in a crossed renal ectopia?
In the normal spot
- important to know for patients with renal colic
Horseshoe kidney
Fusion occurs prior to ascent usually at the lower poles
What should be measured with a horseshoe kidney?
The isthmus
Where does a horseshoe kidney lay?
Anterior to Aorta and other great vessels
What can a horseshoe kidney result in? (4)
- Obstruction
- Infection
- Stone formation
- Hydronephrosis
Why do we measure the isthmus with a horseshoe kidney?
There is an increase risk of developing a neoplasm
How many subtypes of horseshoe kidneys are there?
6
- a-f
What are 6 anomalies related to ureteral bud?
- Renal agenesis
- Congenital Megacalicies
- Congenital Megaureter
- Supernumerary kidney
- Duplex collecting system and Ureteroceles
- Ureteropelvic Junction Obstruction
Unilateral renal agenesis
Is an incidental finding with an apparent compensatory hypertrophy of the single kidney
Bilateral renal agenesis
Is a rare anomaly and incompatible with life
What is renal agenesis associated with? (2)
- Genital tract anomalies
- Mullerian duct - High blood pressure
What is usually present with renal agenesis?
Adrenal glands
What do you have to be careful with renal agensis?
Is the colon falls into the empty renal bed so dont mistake the loop of gut for kidney
What is another term for megacalicies?
Puigverts disease
Megacalicies
Unilateral nonobstructive enlargement of the calyces
Do megacalicies have normal parenchyma and renal function?
Yes
How is puigverts seen on US?
Numerous clubbed calyces
- dilated
What can occur with megacalyces? (2)
- Infection
2. Stones occur
Megaureter
Functional ureteric obstruction, however, the distal ureter segment is aperistaltic
How does megaureter appear?
As fusiform dilation of distal third
Who are more affected by the megaureter?
Men
