Sushma RK, Antony Sylvan DSOUZA

Horse-shoe Shaped Kidney in Fetusand its Associated Variations: A Case Report

Horseshoe kidneys are found in 3% of the population and are probably the most common of all renal fusion anomalies. This anomaly consists of two distinct renal masses lying vertically on either side of the midline and connected at their respective lower poles by a parenchymatous or fibrous isthmus. In a male fetus, aged 32 weeks of gestation, horseshoe kidney was observed during anatomical dissection. Variations in the position of the ureter and the arterial supply were also noted. Although most cases of horseshoe kidneys are asymptomatic and discovered upon autopsy, the condition may increase the risk for ureteric obstruction, venacaval obstruction owing to abnormal placement of ureter, renal infections associated with vesicoureteral reflux, renal stones due to deviant orientation of kidneys combined with slow urine flow and increased risk of renal cancer.

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1. Buntley D. Malignancy associated with horseshoe kidney. Urology. 1976;8(2):146-8.

2. Glen JF. Analysis of 51 patients with horseshoe kidney. N Engl J Med. 1959;261:684-7.

3. Kim HH, Kim YH, Bae DH, Lee HK. Prenatal ultrasound of horseshoe kidney: A case report. J Korean Soc Med Ultrasound. 1998;17(2):165-8.

4. King KL, Kofinas AD, Simon NV, Clay D. Antenatal ultrasound diagnosis of fetal horseshoe kidney. J Ultrasound Med. 1991;10(11):643-4.

5. Sherer DM, Cullen JB, Thompson HO, Metlay LA, Woods JR Jr. Prenatal sonographic findings associated with a fetal horseshoe kidney. J Ultrasound Med. 1990;9(8):477-9.

6. Bronshtein M, Yoffe N, Brandes JM, Blumenfeld Z. First and early second-trimester diagnosis of fetal urinary tract anomalies using transvaginal sonography. Prenat Diagn. 1990;10(10):653-66.

7. Sadler TW. Urogenital system. In Langman's Medical Embryology. 7th edition. Williams & Wilkins: Baltimore, 1995;272-311.

8. Domenech-Mateu JM, Gonzalez-Compta X. Horseshoe kidney: a new theory on its embryogenesis based on the study of a 16-mm human embryo. Anat Rec. 1988;222(4):408-17.

9. Hohenfellner M, Schultz-Lampel D, Lampel A, Steinbach F, Cramer BM, Thuroff JW. Tumor in the horseshoe kidney: clinical implications and review of embryogenesis. J Urol. 1992;147(4):1098-102.

10. Evans WP, Resnick MI. Horseshoe kidney and urolithiasis. J Urol. 1981;125(5):620-1.

11. Bennani S, Touijer A, Aboutaieb R, el Mrini M, Benjelloun S. Pathological horseshoe kidney. Therapeutic aspects. Ann Urol (Paris). 1994;28(5):254-7.

12. Hellstrom P, Ottelin J, Siniluoto T, Paivansalo M, Kyllonen AP. Renal cell carcinoma in horseshoe kidney associated with Turner syndrome and caval extension. Urology. 1989;34(1):46-8.

13. Schubert RA, Soldner J, Steiner J, Schubert J, Kaiser WA. Bilateral renal cell carcinoma in a horseshoe kidney: preoperative assessment with MRI and digital subtraction angiography. Eur Radiol. 1998;8(9):1694-7.

14. Walsh PC, Retik AB, Vaughn ED, Wein AJ, eds, Campbell's Urology. 8th editions. Philadelphia: Saunders. 2002:463-512.

15. Boatman DL, Cornell SH, Kolln CP. The arterial supply of horseshoe kidneys. Am J Roentgenol Radium Ther Nucl Med. 1971;113(3):447-51.

16. Tae-Hoon Kim. Renal Cell Carcinoma in a Horseshoe Kidney and Preoperative Superselective Renal Artery Embolization: A Case Report. Campbell's urology. 8th edition. Vol 3. Philadelphia: WB Saunders. 2005;1885-1924.

17. Zipitis CS, Augustine T, Tavakoli A, Surange R, Agrawal A, Riad HN. Horseshoe kidney transplantation. Surgeon. 2003;1(3):160-3.

18. Basar H, Basar R, Basar M, Erbil M. The comparison of the incidence of horseshoe kidney in autopsy cases versus urologic patient population. Okajimas Folia Anat Jpn. 1999;76(2-3):137-9.