Case Report on Diaphragmatic Hernia with Renal Ectopia as a Cause of Low Back Pain and Dyspnea
Juan Octaviano González Ambriz *
Department of Radiology, Hospital General "Dr. Miguel Silva", Morelia, México.
Agustín Parra Macías
Department of Radiology, Hospital General "Dr. Miguel Silva", Morelia, México.
*Author to whom correspondence should be addressed.
Abstract
Aims: In this case report, we evaluate a case of a diaphragmatic hernia with renal ectopia.
Presentation of Case: We present the case of an adult, male patient with low back discomfort and dyspnea, imaging techniques revealed a mediastinal mass and a large left diaphragmatic defect with renal ectopia.
Discussion: This case emphasizes the importance to rule out renal ectopia in individuals with atypical symptoms. Renal ectopia is a rare condition, becoming more frequent in adulthood because of the increased use of image acquisitions. A left diaphragmatic defect and an extension of the superior renal pole into the thorax were seen on our patient's imaging, which is consistent with intrathoracic renal ectopia. While many people with good renal function have no symptoms, issues including reflux and kidney stones can arise. In these circumstances, individualized, multidisciplinary care is required, and in more severe cases, surgery may be necessary.
Conclusion: Even though intrathoracic renal ectopia is uncommon, this case emphasizes the value of doing a thorough assessment, considering congenital defects such renal ectopia, in individuals presenting with atypical symptoms.
Keywords: Diaphragmatic hernia, renal ectopia, intrathoracic kidney, lumbalgia
How to Cite
References
Donat SM, Donat PE. Intrathoracic kidney: A case report with a review of the world literature. J Urol. 1988;140(01):131–133.
Sesia SB, Haecker FM. Late-presenting diaphragmatic hernia associated with intrathoracic kidney: Tachypnea as a unique clinical sign. BMJ Case Rep. 2012;2012:x.
Karaoglanoglu N, Turkyilmaz A, Eroglu A, Alici HA. Right-sided Bochdalek hernia with intrathoracic kidney. Pediatr Surg Int. 2006;22(12):1029–1031.
Chong SL, Chao SM. An unusual cause of mediastinal mass: A case report and literature-review of intrathoracic kidney. Proc Singapore Healthcare. 2012;2:144–150.
Kayıran PG, Gumus T, Kayıran SM, Bilge I, Gurakan B. Ectopic intrathoracic kidney with right-sided congenital diaphragmatic hernia. J Pediatr. 2013;163(04):1226–1226.e1.
Fiaschetti V, Velari L, Gaspari E, Simonetti G. Adult intrathoracic kidney: A case report of Bochdalek hernia. Case Rep Med. 2010;2010. DOI: 10.1155/2010/975168. Epub 2010 Aug 30.
Chow JS, Benson CB, Lebowitz RL. The clinical significance of an empty renal fossa on prenatal sonography. J Ultrasound Med. 2005;24(08):1049–1054, quiz 1055–1057.
Grotas AB, Phillips JL. Renal mass in solitary, crossed, ectopic pelvic kidney. Urology. 2009;73(06):1223–1224.
Lee CH, Tsai LM, Lin LJ, Chen PS. Intrathoracic kidney and liver secondary to congenital diaphragmatic hernia recognized by transthoracic echocardiography. Int J Cardiol. 2006; 113:E73e5.
Coşkun F, Cetinkaya M, Cengiz O, Adsan O, Kulaçoğlu S, Eroğlu A. Metastatic carcinoma of the gallbladder due to renal cell carcinoma in the ectopic kidney. Acta Chir Belg. 1995;95(01):56– 58.
¹⁸b. Fadaii A, Rezaian S, Tojari F. Intrathoracic kidney presented with chest pain. Iran J Kidney Dis. 2008;2:160e2.
Basoglu T, Canbaz F, Bernay I, Sahin M. Technetium-99m-DTPA images of a renal cell carcinoma arising in a crossed-ectopic fused kidney. J Nucl Med. 1998;39(06):9A, 949.
Fadaii A, Rezaian S, Tojari F. Intrathoracic kidney presented with chest pain. Iran J Kidney Dis. 2008;2:160e2.
Mizzi C, Farrugia D, Choudhry MS. Congenital diaphragmatic hernia with intrathoracic renal ectopia: Thoracoscopic approach for a complete anatomical repair. European J Pediatr Surg Rep. 2020 Jan;8(1):e74-e76. DOI: 10.1055/s-0039-3402741. Epub 2020 Oct 21. PMID: 33101834; PMCID: PMC7577787.
Angulo JC, Lopez JI, Vilanova JR, Flores N. Intrathoracic kidney and vertebral fusion: A model of combined misdevelopment. J Urol. 1992;147(05): 1351–1353.