Ectopic Thoracic Kidney in a Child with Congenital Diaphragmatic Hernia

Abstract

Thoracic ectopic kidney with partial or complete renal protrusion above the level of the diaphragma into the posterior mediastinum is the rarest form of all ectopic kidneys with an incidence of less than 1 per 10,000 cases. We present a newborn with right congenital diaphragmatic hernia associated with thoracic ectopic kidney. The diagnosis of ectopia was made prior to surgery. Gerota's fascia of kidney was used to close the diaphragmatic defect. Since this renal anomaly is usually asymptomatic, it does not require any specific treatment. However, a close examination of function and anatomy of the kidney prior to surgery of hernia is important and beneficial. We discuss the embryological context and the importance of renal scintigraphy in patients with ectopic kidney.

Late-presenting congenital diaphragmatic hernia associated with ectopic thoracic kidney

“…When a CDH has been diagnosed, it must be promptly treated surgically in order to prevent complications and a potentially fatal outcome [4]. After the patient was treated with oxygen and fluid supplementation, primary operative repair was successfully carried out for the diaphragmatic hernia.…”

Right-sided Bochdalek hernia with ectopic intrathoracic kidney: Case report and review of the literature

“…Birçok olguda, intratorasik böbrek yeterli damar uzunluğuna sahip olduğu için hemodinamik bozulmaya yol açmadan abdominal kaviteye kolaylıkla indirilebilmektedir (7) . İndirilen böb-rek sonraki takiplerde renal doppler ultrasonografi ve renal kortikal sintigrafi ile izlenmelidir (9) .…”

Kidney, Urinary Bladder, and Ureter

“…The kidney usually has a rotation anomaly with the hilus facing anteriorly, a high origin of the renal vessels, a long normal ureter, and medial deviation of the lower pole. Nevertheless, the function of the affected kidney is usually well preserved (Sözübir et al 2005;Obatake et al 2006;Dingeldein et al 2008;Fadaii et al 2008). A combination of intrathoracic liver and kidney has been reported (Lee et al 2006).…”

“…The diagnosis is confirmed by CT or contrast-enhanced CT scan and intravenous urography or magnetic resonance imaging of the kidney (William and Jeans 1996;Clarkson and Potter 2009). Renal cortical scintigraphy could be used to confirm the functional status of the kidney tissue (Louzir et al 1999;Sözübir et al 2005). In a reported case of atypical chest pain after myocardial scintigraphy that revealed a large thallium-avid mass in the right hemithorax, subsequent photon emission computed tomography/computed tomography demonstrated the mass to be an ectopic kidney (Du et al 2010).…”