Horseshoe kidney

Horseshoe kidney

This is the most common renal fusion anomaly , occurring in about1 in 400 live births with a male predominance. The isth mus lies at the level of the fourth to fifth lumbar vertebrae (fused lower poles). This causes failure to ascend and rotate so that the renal pelvis faces anteriorly and vertically with the malrotated calyces pointing posteromedially ( Figure 82.2 ). T he vascular supply is variable and the ureter may insert high on the renal pelvis. Most horseshoe kidneys (HSKs) are asymptomatic but they are associated with an increased incidence of genital anomalies, PUJ obstruction (PUJO) and stone formation. The incidence of Wilms’ tumour is higher in HSK. Carl Max Wilhelm Wilms , 1867–1918, German surgeon, described Wilms’ tumour in 1899.

The pathophysiology and management of renal and • ureteric stone disease Trauma to the kidney and ureter • Presentation and management of renal neoplasms •