update to earlier case, patient with left loin pain, microsc | Figure 1

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Emergency Medicine

update to earlier case, patient with left loin pain, microscopic hematuria and possibly some hydronephrosis left kidney, CT-KUB obtained to exclude urolithiasis, no convincing stones/obstruction seen, but kidney size is notably larger than right, what do you think is going on?

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67yo, past history of partial hysterectomy and left ooforectomy leading to iatrogenic left kidney atrofy. Diagnosed with urotelial Carcinoma of upper urinary tract of right kidney. Refused treatment. Progressed to massive haematuria due to 3 large vesical masses. Product of entre bloc ressectoscópio of right and left kidney + bladder + uterine cervix + right ovary. Double J stent on right ureter.


Coronal T2-weighted MRI (images 1 and 2) and 3-D reformatted image (image 3) show three distinct kidneys. Supernumerary kidneys can be associated with urogenital anomalies and duplication. Supernumerary kidneys are typically left-sided and below the primary kidney. When evaluating a supernumerary kidney it is important to determine its vascular supply and ureteral course. #TummyTuesday #AbdomenTuesday


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