ABSTRACT
Renal ectopia anatomically results from altered migration of kidneys to their normal position in the lumbar region. Few case reports have been reported in literature. Visceral-tissue variation was in form of quadratus lumborum and psoas major in place of the RT kidney. A 21 year old female with positive HCG (pregnancy test) presented for radiological (ultrasound) confirmation of cyesis, though no sonic evidence of gravidae was observed (< 5 wks GA); confirmatory ectopic kidney was diagnosed on completion of ultrasound. This report underscores the importance of imaging the RT groin and illiac region before surgical intervention thus preventing iatrogenic injury genesis. Treatment of this condition will depend on the functional capacity of the kidney, while nephrectomy is recommended for ‘static’ non-functional kidneys. Non-complicated cases and anatomic variation can be managed conservatively.
ABSTRACT
Wandering spleen is an uncommon clinical entity, which rarely affects children and adolescents. It is usually described in adults, being most common in the multiparous women of childbearing age. A case of a 14-year-old girl with a past history of splenomegaly and immunoglobulin A (IgA) deficiency, who presented with a sudden onset of abdominal pain, is presented. Diagnosis of hemoperitoneum secondary to torsion of a wandering spleen was made by computed tomography scan and Doppler ultrasound. Laparoscopy revealed hemoperitoneum owing to a ruptured and infarcted spleen. Laparotomy was undertaken and open splenectomy was successfully performed. The patient was discharged after an uneventful postoperative course that was not punctuated by any major complication. Management of this rare surgical emergency is discussed. Based on the details of this case, the authors hypothesize that IgA deficiency causes splenomegaly, which in turn predisposes to ligamentous laxity and splenic torsion.