Crossed Fused Ectopia of Kidney – An Account of Tertiary Healthcare Center Experience

Table 1: The summary of seventeen cases of CRE with the management.

Case	Age/Sex	Clinical Profile	Creatinine mg/dl	Imaging	CROSSED RENAL ECTOPIA	FUSION	Kidneys	Ureters	ASSOCIATED ANOMALY	MANAGEMNET	FOLLOW-UP
1	3m/Male	Antenatally detected hydronephrosis	0.6	USG IVU MCU	Left to right	Superior	Left gross hydronephrosis Right hydroureteronephrosis	Left atretic ureter	Right grade III VUR Hydrocephalus Meckels Diverticulum	Left Nephroureterectomy Intestinal resection and anastomosis with Meckels diverticulectomy	USG abdomen and pelvis, urine analysis 1st, quarterly for year, then yearly once.
2	31y/Male	Recurrent urinary tract infection	1.1	USG CECT MCU	Right to left	L- Shaped	Bilateral hydroureteronephrosis	Bilateral dilated ureters	Bilateral Grade IV VUR	Cohen cross trigonal reimplantation	USG abdomen and pelvis, urine analysis 1st, quarterly for year, then yearly once. DMSA scan/MCU 6th month
3	17y/Male	Recurrent urinary tract infection	1.0	USG CECT RGP	Right to left	Cake/ lump	Bilateral hydronephrosis	Left atretic ureter	Left orifice hypoplastic	Bridged Boari Flap (short flap)	USG abdomen and pelvis, urine analysis 1st, quarterly for year, then yearly once.
4	40y/Male	lower abdominal pain, impaired renal function, sepsis	4.6	USG NCCT NEPHROSTOGRAM RGP	Right to left	Disc/ Doughnut	Right mild hydronephrosis Left gross hydronephrosis	Bilateral Pelviureteric junction obstruction	Right kidney- crossing vessel	(B/L) Anderson Hynes dismembered pyeloplasty	USG abdomen and pelvis, urine analysis 1st, quarterly for year, then yearly once.
5	50y/Female	Right loin pain	0.9	USG CECT	Left to right	L- shaped	Right hydronephrosis with 2cm pelvic calculi	Normal	Renal calculi; UTI	Laparoscopy assisted percutaneous nephrolithotmy	USG abdomen and pelvis, urine analysis 1st, quarterly for year, then yearly once.
6	10y/Female	Urinary tract infection	1.0	USG CECT	Left to right	S- Shaped	Normal	Normal	UTI	Antibiotics	DTPA scan 6th monthly.
7	50y/Female	right loin pain	1.1	USG CECT	Left to right	Disc/ Doughnut	Normal	Normal	Nil	Analgesic	USG abdomen and pelvis, urine analysis 1st, quarterly for year, then yearly once.
8	42y/Male	left loin pain	1.0	USG CECT	Right to left	L- shaped	Normal	Normal	Nil	Analgesic	USG abdomen and pelvis, urine analysis 6 month for a year, then yearly once.
9	34y/Female	Left loin pain Primigravida 30wks gestation	1.2	USG MRI	Right to left	Disc/ Doughnut	Right hydronephrosis	Left atretic ureter	Left hypoplastic orifice	Left USG guided double ‘J’ stenting	USG abdomen and pelvis, urine analysis 6 month for a year, then yearly once.
10	34y/Male	asymptomatic	1.0	USG NCCT	Left to right	inferior	Normal	Normal	Nil	Regular follow-up	USG abdomen and pelvis, urine analysis 6 month for a year, then yearly once.
11	45y/Male	asymptomatic	1.0	USG CECT	Left to right	Disc	Normal	Normal	Nil	Regular follow-up	Post-delivery- Anderson Hynes pyeloplasty.
12	38y/Male	asymptomatic	0.9	USG CECT	Right to left	L-shaped	Normal	Normal	Nil	Regular follow-up	USG abdomen and pelvis, Urine analysis yearly. To report in case of pain/ UTI
13	42y/Female	Bleeding per vagina	1.0	USG NCCT	Left to right	Disc	Normal	Normal	Nil	Regular follow-up	USG abdomen and pelvis, Urine analysis yearly. To report in case of pain/ UTI
14	41y/Male	asymptomatic	1.2	USG CECT	Right to left	L-shaped	Normal	Normal	Nil	Regular follow-up	USG abdomen and pelvis, Urine analysis yearly. To report in case of pain/ UTI
15	32y/Female	asymptomatic	1.1	USG CECT	Left to right	Disc	Normal	Normal	Nil	Regular follow-up	USG abdomen and pelvis, Urine analysis yearly. To report in case of pain/ UTI
16	36y/Female	asymptomatic	1.2	USG CECT	Left to right	S- shaped	Normal	Normal	Nil	Regular follow-up	USG abdomen and pelvis, Urine analysis yearly. To report in case of pain/ UTI
17	39y/Male	asymptomatic	1.0	USG NCCT	Right to left	L-shaped	Normal	Normal	Nil	Regular follow-up	USG abdomen and pelvis, Urine analysis yearly. To report in case of pain/ UTI

USG- Ultrasound, IVU-intravenous Urogram, MCU- Micturating Cystogram, CECT- Contrast Enhanced Computed Tomography, RGP-Retrograde Pyelogram