Atypical presentation of obstructing urolithiasis in a patient with a congenital pelvic kidney

A congenital pelvic kidney is when the organ is located within the pelvis rather than its usual position in the retroperitoneal space of the lumbar region. They are often asymptomatic and therefore usually found incidentally. We present the case of a man in his 60s who presented to our emergency department with left iliac fossa pain and diarrhoea.Contrast CT scanning identified a left congenital pelvic kidney with an obstructing ureteric stone causing severe hydronephrosis. Following successful ureteroscopy, lithotripsy and ureteric stenting, the patient recovered and was discharged home. Although rare, altered renal anatomy can cause atypical presenting symptoms with an otherwise classical pathology of renal stones.