Renal thoracic ectopia. A case report

[Thoracic kidney: congenital or traumatic origin?]

The discovery of a thoracic kidney in adult patients can lead to three diagnoses, yielding different prognoses and treatment. It can either mean traumatic or congenital diaphragmatic hernia, or a congenital ectopic kidney. Intrathoracic herniation of the left kidney trough a left diaphragmatic rupture is an exceptional discovery. We report the case of a 44 year-old man who met with a car accident 20 years ago, and presented abdominal pain. CT-scan showed an intrathoracic herniation of the left kidney trough a left posterior diaphragmatic rupture. Laparoscopic approach in lateral position showed a traumatic hernia of the left costo-diaphragmatic hiatus only containing the left kidney and its pedicle. After reduction of herniated left kidney into the abdomen, the hiatus was closed by non-resorbable prosthetic mesh. Postoperative course was uneventful.

Cephalad renal ectopia, duplication of pelvicalyceal system and patent ductus arteriosus in an adult female

An unusual cause for a shadow in the plain CX-ray of a female with uncomplicated patent ductus arteriosus is presented herein. The chest CT scan and IVU revealed the presence of a high (cephalad) right kidney in an eventrated hemidiaphragm. A bifid ureter and duplication of the pelvis were found in the contralateral kidney. This constellation of anomalies is exceedingly rare.