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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.
Computed tomogram showing congenital abnormality.
Computed tomogram showing situs inversus.
QUESTIONS
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Name the congenital renal anomaly identified in fig 1.
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What is the incidence and sex ratio of this anomaly?
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What complications occur with this condition?
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Name three other genitourinary anomalies that can be associated with this condition.
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