IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Malrotated duplex kidney

Case contributed by Matthew Lukies
Diagnosis certain

Presentation

Abdominal pain for investigation on the background of hypertrophic obstructive cardiomyopathy (HOCM).

Patient Data

Age: 20 years
Gender: Male
ct
  • single-lead pacemaker in situ

  • no cause for the patient's abdominal pain was identified

  • incidental finding of an anterolaterally facing malrotated duplex left kidney with a duplex collecting system draining into a single ureter

  • two left renal arteries, with the inferior artery arising from the left common iliac artery and passing posterior to the kidney

  • three left renal veins, one passing anterior to the aorta and draining into the right IVC, one joining a left ascending lumbar vein and passing retroaortic into the IVC, and one passing posterior to the kidney to drain into the left common iliac vein

  • two right renal arteries and two right renal veins

Case Discussion

In this case, the duplex collecting system unites into a single ureter at the pelviureteric junction (PUJ), but a duplex collecting system may have two ureters that unite before the vesicoureteric junction (VUJ), called the bifid ureter, or complete duplication, called the double ureter.

The renal malrotation, in this case, would be classified as incomplete, with the hilum and pelvis facing anterolaterally. This is the most common type of renal malrotation, but the renal hilum may face posteriorly (excessive rotation) or further laterally (reversed rotation).

The case findings were a collective effort, with thanks to Dr. Alex Jarema and Dr. George Harisis.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.