Pelvic ectopic kidney with acute pyelonephritis: wolf in sheep's clothing

The American Journal of Emergency Medicine
Yu-Tzu TsaoPauling Chu

Abstract

The differential diagnosis of right lower quadrate pain at the emergency department is quite perplexing. We describe a 38-year-old woman presenting with characteristic clinical and laboratory features of ruptured appendicitis with severe sepsis. However, contrast-enhanced computed tomography scan of the abdomen established the diagnosis of pelvic ectopic kidney with acute pyelonephritis. Antibiotic treatment eventually achieved satisfactory resolution without compromise of renal function. It is should be addressed that, even with the advent of modern imaging modalities, there can be a diagnostic pitfall in general practice when managing right lower quadrate pain in patients with typical presentations of acute appendicitis without sonographic evidence, as illustrated in this case. In conclusion, early recognition using exquisite imaging studies with raised awareness in the clinical setting and prompt antibiotic treatment can avoid unnecessary intervention, preserve renal function, and prevent a life-threatening catastrophe.

References

Dec 13, 2005·The American Journal of Emergency Medicine·Chad HarswickShu B Chan

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Citations

Jun 18, 2010·Surgical and Radiologic Anatomy : SRA·Engin KaraHakan Oztürk
Nov 27, 2019·Journal of Surgical Case Reports·Yaying Eileen Xu, Rasika Hendahewa
May 21, 2021·Nigerian Journal of Surgery : Official Publication of the Nigerian Surgical Research Society·Olalekan John AdepojuAdegbolahan Jacob Fakoya

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