Surg Radiol Anat (2011) 33:81–84 DOI 10.1007/s00276-010-0684-7 123 ANATOMIC VARIATIONS Ectopic kidney with varied vasculature: demonstrated by CT angiography Engin Kara · Nail Can Öztürk · AnÂl Özgür · Altan YÂldÂz · Hakan Öztürk Received: 18 March 2010 / Accepted: 28 May 2010 / Published online: 17 June 2010  Springer-Verlag 2010 Abstract An ectopic kidney was found incidentally in a 20-year-old male patient during the abdominopelvic CT angiography. It was situated on the right side at the abdom- inopelvic junction, partly in the abdomen at the level of the intervertebral disc between L3 and L4 superiorly and partly in the greater pelvis at the level of the promontorium and close to the inferior border of the sacroiliac joints. It was supplied by two arteries which were nearly in the same cal- iber, and each of which branched from the common iliac arteries both close to the aortic bifurcation. There were two renal veins. The larger one which was emerging from the lateral part of the ectopic kidney was draining into the infe- rior vena cava. The smaller one which was the only hilar vessel of the ectopic kidney was draining into the left com- mon iliac vein. The orthotopic left kidney was also supplied by two arteries from the abdominal aorta. Ectopic kidneys pose a problem for any planned surgical intervention given their anomalous blood supply. Ectopic position and varied vasculature can predispose to iatrogenic trauma during interventional radiological and laparoscopic procedures, and emergency operations. Keywords Ectopic · Kidney · CT · Angiography Introduction Normally both kidneys are situated posteriorly behind the peritoneum on each side of the vertebral column, at the level of the upper border of the twelfth thoracic vertebra superiorly and the third lumbar vertebra inferiorly [4]. The kidney may be found in pelvic, iliac, abdominal, thoracic, or contralateral locations due to malascent. Ectopic kidney has a reported frequency of 1:500 to 1:110 [2]. Although no signiWcant diVerence exists in the incidence among sexes, a slightly higher propensity is present for the left side over the right. The majority of patients remain asymptomatic, with most ectopic kidneys discovered as inci- dental Wndings during radiological evaluation. However, surgical intervention is often required for those patients who suVer from recurrent infection, symptomatic ureteropelvic junction obstruction, calculi, or chronic pain [11]. Associated anomalies with renal ectopia are well known and most commonly involve the genitourinary, musculo- skeletal, and cardiovascular systems. In women with renal ectopia 20–66% have abnormalities of either the uterus, vagina or both. In men, associated genital abnormalities are seen in 10–20% of patients, most commonly including unde- scended testes, urethral duplication, and hypospadias [8]. Though often clinically asymptomatic, it is an important diVerential diagnosis in the etiology of pelvic masses or tumors, and pelvic pain, including acute appendicitis. An attempt should be made to look for other congenital anoma- lies, especially in the urogenital structures. Furthermore, the possibility of the renal ectopia being the only solitary kidney must be an important consideration taken into account at all times [3]. Management of large calculi in ectopic pelvic kidneys poses a challenge to the urologist. Risk of injury to surrounding abdominal viscera and vasculature makes open surgery as well as percutaneous E. Kara · A. Özgür · A. YÂldÂz Department of Radiology, Faculty of Medicine, Mersin University, Mersin, Turkey N. C. Öztürk (&) · H. Öztürk Department of Anatomy, Faculty of Medicine, Mersin University, Yenisehir Campus, 33169 Mersin, Turkey e-mail: bassmannail1@yahoo.com