Imaging in Horseshoe Kidney and Complications: A Case Series

Background: The horseshoe kidney is a congenital disorder caused by the fusion of the two kidney poles. Both kidneys fuse, resulting in a U-shaped kidney. Most patients with horseshoe kidneys came after having complications such as hydronephrosis, kidney stones, pelvic ureteric junction obstruction (P.U.J.O.), dysplastic cystic disease, kidney and urinary tract stones, reflux and infection, tumors, and trauma. Therefore, this study aims to provide information about imaging horseshoe kidneys and the complications. Case Presentation: This case series presented three cases of patients with horseshoe kidneys. The first case was a 9-year-old male with complaints of low back pain. The patient underwent an ultrasound and found a suspected right double collecting system with a horseshoe kidney and severe right lower moiety hydroureteronephrosis. CT urography showed horseshoe kidney accompanied by right P.U.J.O. caused severe right hydronephrosis. The second patient was a 60-year-old woman who complained of lower back pain. Ultrasound revealed multiple cysts in both kidneys. Abdominal CT with contrast revealed a horseshoe kidney, left moderate hydronephrosis, hydroureter, multiple simple cysts in both kidneys (Bosniak I), and a complex cyst in the right kidney (Bosniak II). The last patient was a 56-year-old man with complaints of recurrent low back. Ultrasound and abdominal CT with contrast revealed stones and moderate hydronephrosis in the right kidney. There were complex cysts (Bosniak I.I.F.) and heterogeneous density mass in the right kidney (Bosniak IV). Conclusion: Horseshoe kidney is usually asymptomatic unless complications occur. Imaging modalities play an essential role in evaluating patients with horseshoe kidney complications.