HORSESHOE KIDNEY ASSOCIATED WITH TUMOR: REVIEW OF LITERATURE AND CASE REPORT OF RESECTION OF INFERIOR VENA CAVA

Horseshoe kidney and its therapeutic problems. (A review of seventy-one clinical cases)

A review of 71 cases of horseshoe kidney accounting for 0.12% of the total number of patients seen at the Department of Urology, Semmelweis University Medical School, Budapest, over 25 years is presented. The incidence of the abnormality has been found twice as high in males as in females. The proportion of surgical cases has been 57.8%, in agreement with published data. The radiodiagnostic investigations, particularly the functional diagnostic studies, are dealt with in detail. Their decisive importance in the considerations for or against surgery is emphasized.

Massive unilateral non-functioning hydronephrosis in horseshoe kidney

The occurrence of non-function in one half of a horseshoe kidney resulting from hydronephrosis can, if unrecognized, create a serious surgical as well as medical problem. The anterior position of the ureter in relation to the isthmus, as well as strictures and accessory vessels increase the incidence of hydronephrosis, which if severe enough, can go on to non-function. The key diagnostic factor is the observation of the visualised side, which shows the characteristic malrotation of the calyces and the deviation of the long axis of the kidneys; these are associated with a mass effect on the obstructed side, with or without a 'crescent' sign. Five cases of this unusual occurrence are presented.