Case Author(s): Hamid Latifi, M.D./Barry Siegel, M.D. , 3/31/95 . Rating: #D2, #Q4
Diagnosis: Horseshoe Kidney
Brief history:
17-year-old female patient with melena
Images:
Anterior and posterior images of the abdomen, obtained 24 hours after injection of labeled red blood cells.
View main image(gi) in a separate image viewer
Full history/Diagnosis is available below
Diagnosis: Horseshoe Kidney
Full history:
17-year-old girl with melena, who had an upper
endoscopy at an outside hospital showing a
non-bleeding peptic ulcer. The current
examination was performed to evaluate the site of
the patient's gastrointestinal bleeding. The
radiopharmaceutical was administered at an outside
hospital with images showing no evidence of gastrointestinal
bleeding. The patient was brought to Children's
Hospital and a delayed (24-hour) image was obtained.
Findings:
There is no evidence of gastrointestinal bleeding. However,
on the anterior images, a horseshoe kidney is illustrated.
Discussion:
There is excretion of free Tc-99m
pertechnetate and reduced technetium compounds by
the urinary system. Therefore, the kidney and urinary
bladder are visualized as seen on this study. This
horseshoe kidney was an incidental finding.
Followup:
The patient also had Meckel's diverticulum scintigraphy
on 3-28-95, which showed no evidence of ectopic gastric mucosa.
Major teaching point(s):
This case illustrates two points. First, it is important
not to confuse a horseshoe kidney with activity in the
transverse colon. Secondly, this illustrates the
value of an anterior view for imaging of a horseshoe
kidney. When performing renal scintigraphy in a patient with
a horseshoe kidney, an anterior view should be obtained to
visualize the isthmus and the entirety of the kidney.
Differential Diagnosis List
None
ACR Codes and Keywords:
References and General Discussion of Gastrointestinal Bleeding Scintigraphy (Anatomic field:Genitourinary System, Category:Normal, Technique, Congenital Anomaly)
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Case number: gi001
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