Upper urinary tract abnormalities: a case of bilateral kidneys within a left-sided omphalocele

Area of Science:

• Pediatric Surgery
• Medical Imaging
• Developmental Biology

Background:

• Omphalocele, exstrophy, imperforate anus, and spinal defects complex represents a severe spectrum of congenital anomalies.
• Improved survival rates necessitate a thorough understanding of potential anatomical variations for optimal surgical management.
• While upper urinary tract anomalies are uncommon, kidney malposition has been previously documented.

Observation:

• This report details the first documented instance of bilateral kidney herniation into the omphalocele sac.
• The patient presented with the complex of omphalocele, exstrophy, imperforate anus, and spinal defects.
• Prenatal diagnosis of this complex can be challenging.

Findings:

• The kidneys were observed to have herniated bilaterally into the omphalocele sac.
• This represents a previously unreported anatomical manifestation within this complex.
• The upper urinary tract, apart from the herniation, was otherwise unremarkable.

Implications:

• This finding expands the known spectrum of renal anomalies associated with this complex.
• Accurate prenatal imaging and surgical planning are critical for managing such rare presentations.
• Further research into the embryological basis of these herniations may offer insights into prevention or treatment.