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


Anterior and posterior images of the abdomen, obtained 24 hours after injection of labeled red blood cells.

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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.


There is no evidence of gastrointestinal bleeding. However, on the anterior images, a horseshoe kidney is illustrated.


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.


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


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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