Presentation
Abdominal pain.
Patient Data
Empty right renal fossa. Both kidneys are fused in one large kidney with separate pelvicalyceal systems and ureters. The right ureter crosses midline to right side. Each ureter (right, left) drains on a separate vesicoureteric junction, in keeping with crossed fused ectopic kidney.
L5 lateral hemivertebra single ipsilateral posterior neural elements with normal articulations, non-development of its left half. It is partially fused with L4 vertebra. The left inferior articular process of L4 articulates with S1 vertebra. Secondary lower lumbar scoliosis with convexity towards right side.
A Phrygian cap of the gallbladder with no radiodense stones is noted.
Case Discussion
Oral contrast was given to assess bowel loops for abdominal pain. There was an incidental note of L4 lateral hemivertebra and crossed fused renal ectopia.
Hemivertebrae occurring isolated or with other anomalies of the spine are frequently associated with urinary tract abnormalities. One study reported the association in about 66% of patients 1. Another study revealed the occurrence of urogenital anomalies at a rate of 23% with hemivertebrae. The most frequent anomaly observed was ectopic and/or fused kidney 2. This association also can be seen among syndromes like Klipple-Feil syndrome 3 or VACTERL association 4.
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