[Traumatic rupture of a horseshoe kidney]. / Rotura traumática de riñón en herradura.

One-third to one-half of all patients with horseshoe kidney are asymptomatic and the condition is found incidentally. This congenital renal anomaly has shown as a predisponent condition for renal injury in blunt abdominal trauma, but often the degree of injury has a nonoperative therapy. Horseshoe kidney rupture is an exceptional pathology that require a complete diagnostic study to make an adequate management when surgical therapy is indicated. We present a fifteen-year-old male with previously unsuspected horseshoe kidney that suffered an atypical right upper-pole and mesorrenal kidney rupture after low-velocity-impact blunt abdominal trauma. A correct presurgical diagnose let a deferred surgical approach with right lower pole and horseshoe renal isthmus preservation. The trauma conditions, an excesive clinic manifestation, a clinical investigation about known congenital simultaneous anomallies and typical radiological signs, can suggest this infrequent patology. Computed tomography provides the best radiological information.

Rotura traumática de riñón en herradura / Traumatic fracture of a horseshoe kidney

Entre un tercio y la mitad de los riñones en herradura son asintomáticos y se diagnostican incidentalmente. Esta anomalía congénita de fusión se ha mostrado como condición predisponente a la lesión renalante un traumatismo abdominal, aunque con frecuencia el grado de afectación renal no precise cirugía. Más excepcional es el hallazgo de fractura de riñón en herradura, requiriéndose un estudio diagnóstico completo para un manejo adecuado a sus características cuando la cirugía está indicada. Se aporta el caso de un varón de 15 años con riñón en herradura no previamente conocido, que presentó una fractura de localización atípica polar superior y mesorrenal derecha, tras un traumatismo abdominal de baja intensidad. El correcto diagnóstico prequirúrgico permitió una cirugía diferida con preservación del polo renal inferior derecho y del istmo del riñón en herradura. Las características del trauma, la desproporción de la repercusión clínica y la búsqueda de posibles anomalías congénitas asociadas y de signos radiológicos compatibles, pueden orientar esta rara posibilidad diagnóstica, confirmándose el TAC con contraste como la mejor prueba de imagen

One-third to one-half of all patients with horseshoe kidney are asymptomatic and the condition is found incidentally. This congenital renal anomaly has shown as a predisponent condition for renal injury in blunt abdominal trauma, but often the degree of injury has a non operative therapy. Horseshoe kidney rupture is an exceptional pathology that require a complete diagnostic study to make an adequate management when surgical therapy is indicated. We present a fifteen year-old-male with previously unsuspected horseshoe kidney that suffered an atipicright upper-pole and mesorrenal kidney fracture after low velocity impact blunt abdominal trauma. A correct presurgical diagnose let a deferred surgical approach with rigth lower pole and horseshoe renal isthmus preservation. The trauma conditions, an excesive clinic manifestation, a clinical investigation about known congenital simultaneous anomallies and typical radiological signs, can suggest this infrequent patology. Computed tomography provide the best radiological information