Wandering kidney

Introduction The normal renal position is that the renal hilum is equivalent to the first and second lumbar vertebrae, and the side is slightly lower than the left side. When standing, the kidney can be lowered by 2 to 5 cm, which is equivalent to a vertebral body. If it exceeds this range, it is called renal ptosis. In a small number of patients, the kidney is wrapped in the peritoneum and the renal pedicle is loose, can move in the abdomen range, and some even fall into the lower abdomen or pelvis, or across the midline to the contralateral abdomen. This kind of renal ptosis is called the kidney. It is more common in Right. The main symptom is low back pain, which can lead to hydronephrosis or upper urinary tract infection due to ureteral curvature. Often complicated by renal hypoplasia, renal dysplasia, renal vascular malformations and ureteral obstruction.

Cause

Most of the causes are due to the fact that the kidney is affected by the renal blood vessels of the abnormal site during the embryonic period and cannot be reached at the normal position. Generally, the pelvic ectopic kidney is more common, and the ectopic kidney and the thoracic ectopic kidney are rare.

an examination

Related inspection

Ultrasound examination of the kidney

Laboratory and other inspections

First, X-ray inspection:

Intravenous pyelography must be added to the final position to understand the extent of its activity. However, since the kidney must be immediately engraved at the standing position, the kidneys cannot be displayed after the contrast agent is exhausted, so sometimes the kidney has not sagged to the usual position. According to the degree of activity in angiography, it is divided into three categories: mild: renal activity within one vertebral body; moderate: renal activity within two vertebral bodies; severe: renal activity above two vertebral bodies or With hydronephrosis, the ureter is distorted. In some cases, although there is no sagging in the venous pyelography, the diagnosis of renal ptosis can still be made from symptoms, physical examination and ultrasonography.

Second, ultrasound examination:

The activity of the kidney can be obtained between the position of the kidney and the position of the kidney after the activity, half an hour after the low foot height.

Third, the low lying position test:

The patient's head is low in the high position for 3 days (the height of a brick can be raised at the foot of the bed), and the urine routine or hourly urine cell excretion rate is measured before, during, and after the bed, and the symptoms are relieved. . If the blood cells in the urine are significantly reduced or even disappeared after sleep, and the symptoms are relieved, the diagnosis of renal ptosis is supported. If the remission is not relieved, the factors of renal ptosis may be excluded.

Fourth, water injection test:

In order to determine whether the patient's back pain is from the kidney, the cyst can be injected into the renal pelvis after intubation through the ureter until the waist feels pain. If the nature and location of the pain are similar to those in the usual episode, the diagnosis of renal ptosis is supported. If the dissimilarity is negative, it is not a symptom caused by renal ptosis.

Differential diagnosis

Differential diagnosis of the kidney:

First, congenital ectopic kidney: mostly located in the abdomen or pelvic cavity, the position is fixed, the kidney can not be reset after lying down.

Second, the supraorbital or extrarenal tumor compression causes the renal position to decrease. The above situation can be diagnosed by B-ultrasound, excretory urography or CT examination.

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