Case Report
Volume 9 Issue 8 - 2020
Horseshoe Kidney (HSK) with Upper Ureteral Valve Masquerading as Pelvi-Ureteric Junction (PUJ) Obstruction. A Case Report and Review of Literature
Satish Kumar1, Reshma Murali2*, Srinivas3, Ravinder Reddy2 and Asha Thomas4
1Consultant Paediatric Surgeon, Department of Paediatric Surgery, Bangalore Baptist Hospital, Bangalore, India
2General Surgery Resident, Department of General Surgery, Bangalore Baptist Hospital, Bangalore, India
3Consultant Urologist, Department of Urology, Bangalore Baptist Hospital, Bangalore, India
4Consultant Radiologist, Department of Radiology, Bangalore Baptist Hospital, Bangalore, India
*Corresponding Author: Reshma Murali, General Surgery Resident, Department of General Surgery, Bangalore Baptist Hospital, Bangalore, India.
Received: March 09, 2020; Published: July 29, 2020




Abstract

Horseshoe kidney (HSK) is most common type of renal fusion anomaly with high incidence of hydronephrosis due to pelviureteric junction obstruction (PUJO) and has been increasingly diagnosed antenatally. Upper ureteral valve obstruction presents like PUJO and progression of hydronephrosis can be rapid which may need early intervention. Here we have reported a rare case of upper ureteral valve in HSK whose antenatal ultrasonography showed evidence of HSK and right hydronephrosis and was postnatally diagnosed to have HSK with right sided hydronephrosis. RGP showed reduced differential renal function on right side (35%) with obstruction at PUJ. On pyelotomy, ureteral valve was confirmed causing obstruction to the proximal ureter. A standard pyeloplasty was performed with stent placement. Upper ureteral valve causing hydronephrosis, which was difficult to differentiate from PUJ obstruction on imaging. In our study we have are highlighting the importance of RGP in such uncommon presentations.

Keywords: Horseshoe Kidney; PUJ Obstruction; Hydroureteronephrosis; Upper Ureteral Valve

References

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  3. Je BK., et al. “Incidence and Spectrum of Renal Complications and Extrarenal Diseases and Syndromes in 380 Children and Young Adults with Horseshoe Kidney”. American Journal of Roentgenology 6 (2015): 1306-1314.
  4. Hardik S and Vijayanadh O. “Multimodality imaging spectrum of complications of horseshoe kidney”. Indian Journal of Radiology and Imaging2 (2017): 133-140.
  5. O'Brien J., et al. “Imaging of horseshoe kidneys and their complications”. Journal of Medical Imaging and Radiation Oncology3 (2008): 216-226.
  6. Rossi E., et al. “Congenital ureteral valves: Two new cases and a review of the literature”. Journal of Pediatric Urology 5 (2007): 344-349.
  7. Rabinowitz R., et al. “Ureteral valves in children”. Urology5 (1998): 7-11.
  8. Maizels M and Stephens FD. “Valves of the ureter as a cause of primary obstruction of the ureter: anatomic, embryologic and clinical aspects”. Journal of Urology 5 (1980): 742-747.
  9. Pandey V., et al. “Mid-ureteric obstruction due to diaphragmatic valve: Case report with review of literature”. IOSR Journal of Dental and Medical Sciences4 (2014): 110-111.
  10. Dewan PA., et al. “Ureterocalycostomy in the management of pelvi-ureteric junction obstruction in the horseshoe kidney”. BJU International 84 (1999): 366-368.
Citation: Reshma Murali., et al. “Horseshoe Kidney (HSK) with Upper Ureteral Valve Masquerading as Pelvi-Ureteric Junction (PUJ) Obstruction. A Case Report and Review of Literature”. EC Paediatrics 9.8 (2020): 204-207.

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