Horseshoe kidney

[3] Although often asymptomatic, the most common presenting symptom of patients with a horseshoe kidney is abdominal or flank pain.

[1] As a result, it is estimated that approximately 25% of patients with horseshoe kidneys are diagnosed incidentally with ultrasound or CT imaging.

[8][9] Kidneys are normally located in the retroperitoneal space between the T12 and L3 vertebrae after ascending from the pelvis during development to rest underneath the adrenal glands.

However, due to the renal fusion, this rotation is impaired resulting in abnormal placement of the ureters.

The diagnosis can be made with many different imaging modalities such as ultrasound, intravenous pyelogram, CT, and MRI.

[1] Common features that can be found on imaging include: Symphysiotomy, which involves separating the fused isthmus in order to release the kidneys, used to be a recommended treatment for this condition but has fallen out of favor due to complications and minimal benefit.

Also, due to the kidney obstruction that can commonly occur with this renal fusion, clearance of the resulting stone fragments can also be impaired.

[1] Additionally, the horseshoe kidneys can have a close association with colon which can increase risk of bowel injury.