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Ginjal tapal kuda dengan hidronefrosis unilateral sekunder akibat atresia ureter: laporan kasus

Abstract

Background: Total prevalence of multiple congenital anomalies (MCA) was 15.8 per 10,000 births. Genitourinary anomalies were associated with MCA cases about 43.8% of the cases. The horseshoe kidney is one example of genitourinary anomalies related to the high incidence of MCA and up to one third also had hydronephrosis thought to be secondary to ureteric atresia.

Case: A 10-month-old boy presented with a 5-month history of abdominal distention. On physical examination, there was a large non-tender cystic mass in the right upper abdomen extending down to the right lower abdomen. The other congenital anomalies on this patient were hydrocephalus, hypospadias, and bilateral undescended testis. Abdominal CT showed a significant right hydronephrosis with megaureter and mesenteric cyst. The horseshoe kidney was unclear. The surgical approach to the kidney was via a transverse upper abdominal transperitoneal incision. Exploration revealed a horseshoe kidney with cystic mass situated retroperitoneally on the right side, massive dilatation of renal pelvis and proximal ureter 3 cm from UPJ. The distal ureter was markedly atresia. It was decided to perform nephroureterectomy on the right side considering its thin renal cortex. The postoperative average urine production is 25 ml/hour, no bleeding from surgical wound, BUN 10.7 mg/dL, and serum creatinine 0.37 mg/dL.

Conclusion: The horseshoe kidney is one example of genitourinary anomalies related to the high incidence of MCA. Up to one third with horseshoe kidney had hydronephrosis secondary to ureteric atresia, which can be managed by reconstruction surgery or nephroureterectomy considering the function of the affected side of kidney.

 

References

  1. Sallout B, Obedat N, Shakeel F, Mansoor A, Walker M, Al-Badra A. Prevalence of major congenital anomalies at King Fahad Medical City in Saudi Arabia: a tertiary care centre-based study. Ann Saudi Med. 2015; 35(5):343-51.
  2. Padmanabhan R, Venkatasubramanian R, Heber A. Prevalence and Pattern of Congenital Malformations among Neonates in a Medical College Hospital - A Retrospective Study. Int J Sci Stud. 2019; 6(12):28-31.
  3. Ariani Y, Soeharso P, Sjarif DR. Genetics and genomic medicine in Indonesia. Molecular Genetics & Genomic Medicine. 2017; 103-9.
  4. Calzolari E, Barisic I, Loane M, Morris J, Wellesley D, Dolk H, et al. Epidemiology of Multiple Congenital Anomalies in Europe: A EUROCAT Population-Based Registry Study. Wiley Online Library. 2014.
  5. Duarsa GWK, Nugroho TD. Characteristics of Hypospadias Cases in Sanglah General Hospital, Bali-Indonesia: A Descriptive Study. Bali Med J. 2016; 5(1):13-16.
  6. Shapiro E, Telegrafi S. Anomalies of the Upper Urinary Tract. Dalam: Campbell-Walsh Urologi, 11th Ed.. Elsevier Inc. 2016; p.2993-6.
  7. Natsis K, Piagkou M, Skotsimara A, Protogerou V, Tsitouridis I, Skandalakis P. Horseshoe kidney: a review of anatomy and pathology. Springer-Verlag France. 2013.
  8. Bhattacharjee PK, Ghosal S, Sharma GD. Distal ureteric atresia presenting as an abdominal lump in an adult. Indian J Surg. 2004; 66:175-7.
  9. Roy SKS, Saha K, Bhattacharjee PK, Majhi TK, Sarkar R. A Distal Ureteric Atresia-A Case Report. J Indian Assoc Pediatr Surg. 2002; 7:156-8.
  10. Bleve C, Conighi ML, Fasoli L, Bucci V, Battaglino F, Chiarenza SF. Proximal ureteral atresia, a rare congenital anomaly—incidental finding: a case report. Transl Pediatr. 2017; 6(1):67-71.
  11. Bagnara V, Castorina S, Nappo SG, Privitera G, Luca T, Caione P. Hypothesis on etiopathogenesis, congenital or acquired, of an imperforate distal ureter: a case report. Journal of Medical Case Reports. 2015; 9:227.
  12. Lee JW, You SH, Han DY, Jeong HJ, Choi DY, Oh YK. Retroperitoneoscopic Nephrectomy for a Horseshoe Kidney with Unilateral Severe Hydronephrosis and Ureteral Hypoplasia. Korean Journal of Urology. 2009; 50(5):512-5.
  13. Tekgul S, Dogan HS, Hoebeke P, Kocvara R, Nijman JM, Radmayr C, et al. Dilatation of the upper urinary tract. Dalam: European Association of Urology Guidelines on Pediatric Urology. 2016; 49-51.
  14. Sigumonrong Y, Santosa A, Rodjani A, Tarmono, Duarsa GWK, Daryanto B, et al. Panduan Penatalaksanaan Urologi Anak di Indonesia 2016. Ikatan Ahli Urologi Indonesia. 2016; 2:18-41.
  15. Al-Shamsi A, Abudaia J, Al-Sabban E, Ahmed S. Horseshoe kidney with hydronephrosis secondary to ureteric stenosis: construction of a ureter from the renal pelvis. BJU International. 1999; 83:146-7.
  16. Prakash A, Saxena D. Horse Shoe Kidney With Uretero-Pelvic Junction Obstruction: Insights In Embryology And Management. Pediatr Neonatal Care. 2017; 7(3):00289.
  17. Ashimine S, Miyazato M, Hayashi E, Morozumi M, Sugaya K, Ogawa Y. Distal ureteral atresia: Recovery of renal function after relief of obstruction at ten months old. International Journal of Urology. 2005; 12:578–80.
  18. Morozumi M, Ogawa Y, Fujime M, Kitagawa R. Distal Ureteral Atresia Associated with Crossed Renal Ectopia with Fusion: Recovery of Renal Function after Release of a 10-Year Ureteral Obstruction. Int J Urol. 1997; 4:512-5.

How to Cite

Darma Pratama, P. K., Duarsa, G. W. K., Nilawati, G. A. P., & Anandasari, P. P. Y. (2019). Ginjal tapal kuda dengan hidronefrosis unilateral sekunder akibat atresia ureter: laporan kasus. Intisari Sains Medis, 10(2). https://doi.org/10.15562/ism.v10i2.594

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Putu Kurnia Darma Pratama
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Gede Wirya Kusuma Duarsa
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Gusti Ayu Putu Nilawati
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Pande Putu Yuli Anandasari
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