Test Yourself

Case 1

HISTORY

An elderly man presented with hypotension and collapse. A diagnosis of urosepsis was made and an ultrasound requested to exclude an obstructed, infected kidney. He denied any previous renal history.

ULTRASOUND FINDINGS

There was a moderate amount of ascites. Neither the left nor right kidneys could be identified in the usual position, so the pelvis was examined which revealed a horseshoe kidney with dilation of the right collecting system.

DISCUSSION

Causes of inability to find a kidney include nephrectomy, congenital aplasia or hypoplasia or ectopic location (such as a pelvic, crossed ectopic or horseshoe kidney). The kidneys in chronic renal failure are often shrunken and hyperechoic with loss of the cortico-medullary differentiation, making them difficult to identify.

SUBMITTED BY

Adrian Goudie

Right Upper Quadrant

Right Upper Quadrant

Free fluid is seen but there is no identifiable kidney
Right Upper Quadrant Left Upper Quadrant Right iliac fossa Right Iliac Fossa Trans (Sup>Inf) Infra Umbiliacal Trans InfraUmb Trans Sup>Inf Left Iliac Fossa Left Iliac Fossa