Horseshoe kidney

Bilateral dystopia of the kidneys, where they grow together among themselves lower or upper poles, called horseshoe kidney. More than 90% of cases of renal grow together bottom poles. The isthmus between neighboring kidney has a different thickness (Fig. 53).

Fig. 53. Horseshoe kidney.

On sectional data, horseshoe kidney meets once 500-700 autopsies.
If the kidneys are converging not poles, and all over, then formed the so-called geleobraznye kidney. If the kidneys are converging unlike poles and pelvis their rotated in opposite directions, talk about S-shaped kidney.
If kidney merged the poles so that one lies along the spine, and the second - perpendicular to it, then the kidney called the L-shaped.
Horseshoe kidney has all the hallmarks dystopic kidney: it is located below normal, vessels depart randomly, pelvis are on the front surface of the kidneys, a Cup turned in the medial side, ureters short leave from the lateral edges or the middle of the pelvis and therefore form an angle, open up, not down as normal.
Horseshoe kidney is often not cause any problems. Sometimes patients complain of pain in the lower abdomen, in the navel, constipation, dyspepsia. Reasons: pressure dystopic buds on the adjacent organs, obstructed urine flow, pressure isthmus on the aorta, the inferior Vena cava and nerve plexus.
An accurate diagnosis can be made on the basis pielografii, giving the picture typical for dystopia both kidneys (Fig. 54). The image of the kidneys and of the isthmus do best when Pnevmostroimashina.
If the pain is caused by the pressure of the isthmus, dissect it, and then both halves of the sides (Martynov). In testimony affected half of the kidney can be removed.

pyelogram horseshoe kidney
Fig. 54. Pyelogram horseshoe kidney.