PATHOLOGY Renal N* Q-1

[Roxanita]

A 46-year-old man is killed in an automobile accident. The photograph shows his kidneys. Which of the following would have been expected in this patient?

http://www.emedicine.com/radio/images/46734673HK,CT2_28000.jpg

A) Cerebral arterial aneurysms

B) Hypertensive heart disease

C) Multiple hepatic cysts

D) Normal renal function

E) Vesicoureteral reflux

[Roxanita]

The picture shows a HORSESHOE KIDNEY

The horseshoe kidney is the most common type of renal fusion anomaly. It consists of 2 distinct functioning kidneys on each side of the midline connected at the lower poles by an isthmus of functioning renal parenchyma or fibrous tissue that crosses the midline of the body.

Pathophysiology: By itself, the horseshoe kidney does not produce symptoms. However, by virtue of its embryogenesis and anatomy, it is predisposed to a higher incidence of disease when compared to the normal kidney. The variable blood supply, presence of the isthmus, high insertion point, and abnormal course of the ureters all contribute to these problems. Because of these embryogenic and anatomical factors, the rates of hydronephrosis (see Image 1), stone formation, infection, and certain cancers are higher, which results in a diseased horseshoe kidney.

The most common associated finding in horseshoe kidney is ureteropelvic junction (UPJ) obstruction, which occurs in up to 35% of patients. It causes the majority of problems. Associated genitourinary anomalies in horseshoe kidney are common and occur in as many as two thirds of patients. Vesicoureteral reflux is present in approximately half the patients.

http://www.emedicine.com/med/topic2860.htm

http://ndt.oupjournals.org/content/vol14/issue11/images/medium/ND68940.39.1.gif

[BlakeH]

Nice picture!!!!!!

[Lorena]

agree with blake..that is a cool picture, thanks for the explanations Rox