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Pyelonephritis in crossed-fused renal ectopia
Pielonefritis en ectopia renal cruzada y fusionada
A.. Jiménez Pachecoa, M.A.. Arrabal Poloa, M.. Arrabal Martína, A.. Zuluaga Gómeza
a Servicio de Urología, Hospital Universitario San Cecilio, Granada, Granada, España,
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    "textoCompleto" => "<p class="elsevierStylePara">Dear Editor&#58;</p><p class="elsevierStylePara">Crossed-fused renal ectopia is the second most common variety of renal fusion&#44; with an incidence of 0&#46;01&#37; in the general population&#46; There are at least six varieties of crossed-fused renal ectopia&#44; and it is thought to be produced by a change in the migration of the kidney due to a vascular obstacle&#44; or due to genetic or teratogenic factors&#46; It is generally associated with other alterations of the gastrointestinal and locomotor systems&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Clinical case</span></p><p class="elsevierStylePara">Female patient&#44; aged 40 years&#44; with a personal history of recurrent cystitis and two vaginal births&#44; a habitual smoker of 10 cigarettes&#47;day came to the Emergency Room due to pain in the right ileal fossa&#44; fever and urination syndrome&#46; An analysis was performed&#44; which revealed leukocytosis with a left deviation &#40;23&#44;436 leukocytes&#47;ul&#44; 93&#37; segmented&#41;&#44; 456&#44;000 platelets&#47;ul&#44; renal function within normal range &#40;urea 34&#46;1mg&#47;dl and creatinine 0&#46;9mg&#47;dl&#41;&#44; globular sedimentation velocity &#40;GSV&#41; of 42mm&#47;hour within the first hour&#44; Creactive protein at 34&#46;1 and pyuria in the sediment &#40;50 leukocytes per field&#41;&#44; positive nitrite test and bacteria&#46; At that point&#44; a urine culture was extracted that came back positive for Escherichia coli 96 hours later&#46; After extraction of the urine culture&#44; an empirical antibiotic treatment was started with amoxicillin&#47;clavulanic and gentamycine&#59; treatment with both antibiotics was finished&#44; since the antibiogram confirmed that the microorganism was sensitive to them&#46; In the abdominal ultrasound&#44; we see a structure compatible with crossed renal ectopia in the right ileum fossa&#44; which is fused at its upper point with the right kidney&#44; and no kidney in the left renal fossa&#46; With the clinical&#44; analytical and imaging data&#44; the diagnosis of acute pyelonephritis with a crossed ectopic kidney was carried out&#46; An anterograde pyelography was performed&#44; in which both kidneys can be observed fused together and located in the right hemiabdomen &#40;figure 1&#41;&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Discussion</span></p><p class="elsevierStylePara">Crossed ectopia without or with fusion &#40;90&#37; of all cases&#41; occurs when the ectopic kidney is located on the side opposite to its ureter&#8217;s insertion point in the bladder&#46; This is a rare congenital defect&#46;<span class="elsevierStyleSup">1&#44;2</span> At times&#44; blood vessels responsible for irrigating the ectopic kidney cross the midline and can be responsible for stenosis of the pyelourethral union of the ectopic kidney or its normal counterpart&#46;<span class="elsevierStyleSup">3</span> Most of these cases evolve asymptomatically and the diagnosis is made when a disease affects the ectopic kidney&#44; such as an infection&#44; lithiasis&#44; tumours or other more infrequent possibilities&#46;<span class="elsevierStyleSup">1&#44;2&#44;4</span> The diagnosis is performed by ultrasound&#44; intravenous urography or anterograde pyelography&#44;<span class="elsevierStyleSup">5</span> isotopic studies&#44; computed tomography or nuclear magnetic resonance imaging&#46; The treatment for this congenital defect merely concerns the pathology affecting the kidney&#59; no other treatment is necessary if the patient is asymptomatic&#46;</p><p class="elsevierStylePara"><a href="grande&#47;18818078&#95;f1&#95;p278&#46;jpg" class="elsevierStyleCrossRefs"><img src="18818078_f1_p278.jpg"></img></a></p><p class="elsevierStylePara">Figure 1&#46; </p>"
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Article information
ISSN: 20132514
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2017 January 27 4 31
2016 December 60 4 64
2016 November 53 7 60
2016 October 86 5 91
2016 September 86 2 88
2016 August 120 2 122
2016 July 111 9 120
2016 June 99 0 99
2016 May 118 0 118
2016 April 77 0 77
2016 March 54 0 54
2016 February 65 0 65
2016 January 65 0 65
2015 December 104 0 104
2015 November 60 0 60
2015 October 64 0 64
2015 September 53 0 53
2015 August 56 0 56
2015 July 44 0 44
2015 June 34 0 34
2015 May 49 0 49
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?