PMC6521563_01
Initial preoperative CE-CT scan (coronal section) showing horseshoe kidney with right hydronephrosis.
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The preoperative CT scan revealed a horseshoe kidney (HSK) with the right side involved by ureteropelvic-junction obstruction (UPJO) causing gross hydronephrosis and parenchymal thinning (Figures 1 and 2).
Initial preoperative CE-CT scan (axial section) showing horseshoe kidney with the fusion of the lower poles to the left of aorta.
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The preoperative CT scan revealed a horseshoe kidney (HSK) with the right side involved by ureteropelvic-junction obstruction (UPJO) causing gross hydronephrosis and parenchymal thinning (Figures 1 and 2).
CE-CT following laparoscopic right nephrectomy showing leakage of contrast from the residual stump of the right lower pole.
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Subsequently CT urogram was done which showed that a small residual stump of the right kidney fused to the lower pole of the left kidney was still viable and producing and leaking urine (Figure 3).
Intraoperative picture of exploratory laparotomy showing small residual stump of lower pole of right kidney fused to the lower pole of left kidney. Left ureter is seen running over the lower pole of left kidney.
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The stump was freed from the IVC and delivered to the left side from underneath the inferior mesenteric artery (Figure 4).