An unusual presentation of

bilateral pelvic kidney

Prakash.A. , Hussain.S.
Gajdhar.M. , Sharma.D.B.
Department of surgery, NSCBMC,
Jabalpur.
 INTRODUCTION
 Renal ectopia a rare congenital anomaly (1:1000)

 Most commonly ectopic kidney lie in the

pelvis(1:3000)

 Left sided anomaly more common

 Bilateral ectopic pelvic kidney(1:10000)

 CASE REPORT
 20 Year old female presented with
- right lower abdominal pain since 6 mths
- recurrent fever, vomiting, anorexia &
amennorhoea since 2 mths

O/E : firm , tender right iliac fossa lump

extending to hypogastrium

P/V : tender lump through right fornix

 INVESTIGATIONS
 Routine hemogram :
chronic
inflammatory
response

 Renal
function test :
Normal

X ray KUB :
radio opaque density
in
rt hemipelvis
 INVESTIGATIONS

 USG KUB : right pelvic multicystic kidney with

septations & internal echoes
- E/O collection in right iliac fossa, ?
Perforated appendix

 Intravenous Urography
Lt kidney – normally functioning pelvic in position
Rt kidney – not visualised
 INVESTIGATIONS

 Contrast enhanced CT scan

- Bilateral ectopic (pelvic) kidneys

- Lt kidney – normally functioning
- Rt kidney – poorly functioning, calculi with
pyonephrosis with loss of perinephric fat
planes
 MANAGEMENT
 Rt nephrectomy done with rt Gibsons incision
 DISCUSSION
 Rtectopic pelvic kidney with pyonephrosis
may mimic appendicular lump
 Sonography – first investigation
 Pre operative IVU – assesses renal function
 CECT – Investigation of choice
 Avoid injury to iliac vessels & opposite ureter
 MESSAGE

 In any case presenting with right lower

quadrant mass possibility of ectopic pelvic

kidney should always be kept in mind.