Mwita Philipo Felix, Nhungo Charles John, Alexandre Amini Mitamo, Nsato Sylvia Bedas, Mmbando Theofilo, Mtaturu Gabriel, Nyongole Obadia, Mkony Charles A
Department of Surgery, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Radiology, Muhimbili National Hospital, Dar es Salaam, Tanzania.
J Med Case Rep. 2025 Jan 11;19(1):12. doi: 10.1186/s13256-024-04981-7.
Horseshoe kidney is the most common renal fusion anomaly, occurring in approximately 1 in 500 individuals worldwide. It is characterized by abnormalities in kidney position, rotation, and vascular supply. While often asymptomatic, horseshoe kidneys can lead to urological complications, primarily due to ureteric obstruction and impaired urinary drainage.Although ureteropelvic junction obstruction (UPJO) is uncommon in horseshoe kidneys, its occurrence presents unique diagnostic and management challenges. This case explores the etiology, clinical presentation, and surgical management of UPJO in a patient with a horseshoe kidney, highlighting the critical role of urologists in addressing these anatomical and functional complexities.
We report the case of a 3-month-old African male infant who presented with a two-month history of excessive crying and symmetrical abdominal distension. Radiological evaluation revealed a horseshoe kidney with decreased parenchymal thickness in the left kidney and marked hydronephrosis of the pelvis and calyces, with abrupt cessation at the left ureteropelvic junction. Surgical correction of the obstruction was performed successfully. The patient was followed for six months, during which he remained symptom-free with normal renal function tests.
Ureteropelvic junction obstruction in a horseshoe kidney presents unique anatomical challenges. Symptomatic cases require thorough imaging for diagnosis and surgical planning. Pyeloplasty is the typical surgical intervention, meticulously planned to address these complexities. This ensures effective relief of obstructions and proper urinary drainage.
马蹄肾是最常见的肾脏融合异常，全球约每500人中就有1人发病。其特征是肾脏位置、旋转和血管供应异常。马蹄肾通常无症状，但可导致泌尿系统并发症，主要原因是输尿管梗阻和尿液引流受损。虽然肾盂输尿管连接处梗阻（UPJO）在马蹄肾中并不常见，但其发生带来了独特的诊断和管理挑战。本病例探讨了马蹄肾患者UPJO的病因、临床表现和手术治疗，强调了泌尿外科医生在应对这些解剖和功能复杂性方面的关键作用。
我们报告了一名3个月大的非洲男婴病例，该患儿有两个月过度哭闹和对称性腹胀的病史。影像学评估显示为马蹄肾，左肾实质厚度降低，肾盂和肾盏明显肾积水，左输尿管肾盂连接处突然中断。成功进行了梗阻的手术矫正。对该患者进行了6个月的随访，在此期间他无症状，肾功能检查正常。
马蹄肾中的肾盂输尿管连接处梗阻存在独特的解剖学挑战。有症状的病例需要进行全面的影像学检查以进行诊断和手术规划。肾盂成形术是典型的手术干预措施，需精心规划以应对这些复杂性。这可确保有效解除梗阻并实现适当的尿液引流。
