Efficacy and cost-effectiveness of extracorporeal shockwave lithotripsy for solitary lower pole
A contrast-enhanced axial CT image at the level of the lower pole
of the kidneys (Figure 2) shows a bridging isthmus between the right and left kidneys, which is indicative of a horseshoe kidney.
An abdominal ultrasound showed the laceration to the lower pole
of the left kidney with decreased blood flow and an organized hematoma (Fig.
Crescent shaped calcification is noted at the lower pole
of renal shadow.
Magnetic resonance imaging (MRI) was done and T2-weighted coronal images at posterior and anterior planes showed renal graft in the right lower abdomen and both atrophied native kidneys with isointense solid renal mass at lower pole
of the right native kidney measuring 3 x 2.
In previous reported cases, it was found out that although CT and Mill of the abdomen demonstrated a well-defined mass occupying the middle of the right kidney, and a 8 cm low density solid tumor in the lower pole
of the left kidney, in another study CT and MRI of the abdomen demonstated a well-defined semisolid/semicystic mass occupying the lower calyces of the left kidney.
The right upper pole artery (RUPA) crossed posterior to the inferior vena cava (IVC), whereas the right lower pole
artery (RLPA) crossed anterior to the inferior vena cava (IVC).
Abdominal US revealed a focal mass, located in the upper pole of the kidney in three cases (25%), the lower pole
in six cases (50%) and the mid-part in two cases (16.
These were further separated to see if any part of the colon extended directly behind the lower pole
[Figures 1], middle pole and upper pole of the kidney.
Local anaesthesia by 2% lignocaine was used along the needle insertion track to the lower pole
4 cm non-enhancing left lower pole
renal lesion that was felt to be in keeping with a spontaneous hemorrhage of a previously seen renal cyst, although a cystic mass could not be ruled out (Fig.
A well-defined non-tender mass of about 10x8x8cms felt at lower pole
of uterus with fetal head above this mass.