Horseshoe kidney: Morphologic features, embryologic and genetic etiologies, and surgical implications

Area of Science:

• Urology
• Developmental Biology
• Anatomy

Background:

• Horseshoe kidney (HSK) is the most common congenital upper urinary tract abnormality, affecting ~1 in 500 people.
• HSK increases risks for neoplasms, infections, obstruction, trauma, and surgical complications due to complex vascular anatomy.

Observation:

• Review of etiological factors including embryology, genetics, cell signaling, migration, environmental exposures, and trauma.
• Presentation of a unique HSK vascular anatomy case in a 100-year-old male during anatomical dissection.
• Detailed description of HSK structure, abdominal relationships, and associated vascular supply.

Findings:

• HSK etiology involves complex embryological, genetic, and environmental factors.
• Anatomical variations, particularly in vascular supply, are common in HSK.
• Understanding HSK subtypes and etiology aids surgical planning and risk assessment.

Implications:

• Enhanced understanding of HSK etiology and anatomy can improve patient outcomes.
• Knowledge of HSK variations is vital for surgeons to mitigate intraoperative risks.
• This review emphasizes the importance of anatomical knowledge in clinical practice for congenital abnormalities.