Ectopic kidneys are a unique form of congenital anomaly that in most cases remain asymptomatic. However, depending on the location and the associated anatomical variations, they can mimic certain more common conditions, posing a challenge in differential diagnosis. They could cause secondary symptoms by virtue of their location or could falsely mimic a primary urologic problem when the etiology might be from a closely opposed adjacent structure. We present a unique case of ovulatory dysuria in a young female with a crossed non-fused ectopic kidney. The patient's symptoms were recurrent and correlated with the ovulatory phase of the menstrual cycle. Work-up revealed the right ovary to be in close proximity to the pelvis of the ectopic kidney. Salpingo-oophrectomy was followed by complete resolution of the patient's symptoms. The clinical manifestations, work-up, and management of symptomatic ectopic kidneys are briefly discussed in our article. Symptoms are usually attributed only by systematically excluding other causes. Surgical intervention is a last resort option only after thorough work-up with appropriate imaging studies.

Abdominal computed tomography, with the administration of oral and intravenous contrast material, was performed in a 40-year-old woman with long-standing pain in the right lower quadrant and a three-day history of nausea, vomiting, and right-flank pain. For years, the patient had been able to relieve her abdominal pain by applying pressure over the right lower quadrant. The abdominal examination was normal, except for tenderness in the right lower quadrant. The scan showed that a loop of colon (arrow) had herniated through the spigelian line and lay between the internal and external oblique muscles. The patient refused surgery and left the hospital against medical advice.

Cystography is commonly thought to be the sine qua non in the diagnosis of perforation or rupture of the bladder. Recently, we encountered 2 cases of bladder rupture discovered at subsequent exploration in which preoperative cystography had been negative. The reasons for these negative radiographic findings in light of a non-intact bladder are discussed and a technique for cystography is suggested that will reveal disruptions of the bladder with greater certainty.