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Congenital renal anomaly in a patient with situs inversus
  1. P Chaturvedi,
  2. K Thomas
  1. Ysbyty Gwynedd North West Wales NHS Trust, Bangor LL57 2PW, UK
  1. Correspondence to:
 Mr Chaturvedi; 
 patanjali_c{at}hotmail.com

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Answers on p 359.

A 65 year old man was referred to the urology clinic with a two month history of right loin pain. He had no previous urological history. Situs inversus had been diagnosed previously during a routine appendicectomy.

Clinical examination and blood pressure were normal. Laboratory evaluation including blood urea, serum creatinine, 24 hour urinary protein, and urine culture were normal. A plain abdominal radiograph showed no calculi. An ultrasound scan identified a suspicious mass lesion, which demonstrated increased vascularity in the lower pole of the left kidney. A subsequent computed tomogram failed to identify a mass lesion but did reveal a congenital abnormality (fig 1) in addition to the previously diagnosed situs inversus (fig 2). The patient was reassured and discharged with instructions for a regular blood and urine check by his family doctor.

Figure 1

Computed tomogram showing congenital abnormality.

Figure 2

Computed tomogram showing situs inversus.

QUESTIONS

  1. Name the congenital renal anomaly identified in fig 1.

  2. What is the incidence and sex ratio of this anomaly?

  3. What complications occur with this condition?

  4. Name three other genitourinary anomalies that can be associated with this condition.

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