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The intrathoracic kidney: should we fix it?

James J Murphy1, Gabriel Altit, Siham Zerhouni

  • 1Department of Pediatric Surgery, British Columbia Children's Hospital, Vancouver, British Columbia, Canada. jmurphy@cw.bc.ca

Journal of Pediatric Surgery
|May 19, 2012
PubMed

Insights

Intrathoracic kidney is rare in children. Isolated cases without bowel herniation can be safely observed, while those with bowel require surgical repair and nephropexy.

Area of Science:

  • Pediatric Urology
  • Congenital Anomalies
  • Surgical Management

Background:

  • Intrathoracic kidney is a rare congenital anomaly, with limited pediatric case reports and no long-term follow-up data.
  • Management strategies, including operative and nonoperative approaches, have been debated.
  • This study reports the largest pediatric series and evaluates nonoperative management efficacy.

Observation:

  • Five pediatric cases of intrathoracic kidney were prospectively collected and followed long-term.
  • Two patients presented with respiratory distress due to diaphragmatic hernia and underwent repair and nephropexy.
  • Three patients had incidental diagnosis of isolated intrathoracic kidney.

Findings:

  • Long-term follow-up confirmed normal function and development in all five pediatric patients.
  • No late bowel herniation occurred in the nonoperatively managed group.
  • Surgical repair and nephropexy were performed for intrathoracic kidney with associated bowel herniation.

Implications:

  • Nonoperative management is a safe and effective option for isolated pediatric intrathoracic kidney without bowel herniation.
  • Prompt surgical intervention is indicated for intrathoracic kidney associated with bowel in the chest.
  • This study provides crucial long-term data supporting conservative management in select pediatric cases.
Abstract

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