[A tricky issue for the ultrasound technician]

Area of Science:

• Nephrology
• Medical Imaging
• Anatomical Pathology

Background:

• Chronic renal failure and abdominal pain are common presenting symptoms in nephrology.
• Renal anomalies can present with varied clinical manifestations, often discovered incidentally or during investigation of related symptoms.

Observation:

• A 72-year-old woman presented with chronic renal failure and diffuse abdominal pain.
• Initial ultrasonography revealed an abnormally positioned right kidney and a pseudo mass on the left kidney's lower pole.
• Magnetic Resonance Imaging (MRI) identified a complex anatomical anomaly involving kidney dislocation, fusion, and malrotation.

Findings:

• The identified complex renal anomaly was diagnosed as a 'sigmoid kidney'.
• This condition represents a significant deviation from typical renal anatomy, involving multiple structural abnormalities.
• Sigmoid kidney is a rare congenital condition characterized by fused and malrotated kidneys.

Implications:

• Sigmoid kidney can be asymptomatic or lead to significant genitourinary diseases.
• Early detection and understanding of this rare renal anomaly are crucial for managing potential complications.
• This case highlights the importance of advanced imaging in diagnosing complex congenital renal abnormalities.