Horseshoe Kidney Injury Managed With Percutaneous Nephrostomy for Urinoma: A Case Report

TL;DR

A 41-year-old man with a horseshoe kidney injury was successfully treated with percutaneous nephrostomy after conservative methods failed.

Contribution

This case highlights the need for tailored management of horseshoe kidney injuries due to their complex anatomy.

Findings

Horseshoe kidney injuries can lead to complications like urinoma that may require drainage.

Percutaneous nephrostomy was effective in treating the urinoma in this case.

Management of such injuries must consider the unique vascular and urogenital anatomy.

Abstract

Horseshoe kidney injuries are rare, and whether their management is similar to that of common renal injuries remains unclear. We present the case of a 41-year-old man who bruised his abdomen while riding a bicycle and experienced persistent abdominal pain. His vital signs were stable, but he had significant tenderness below the umbilicus. Contrast-enhanced abdominal computed tomography revealed a horseshoe kidney injury, urine leakage, and a urinoma. Conservative treatment was performed, but the urinoma continued to enlarge. Percutaneous drainage was performed on the seventh day in the hospital. The urinoma improved, and the patient was discharged on day 24. As in this case, horseshoe kidney injuries can easily lead to deep damage and associated complications compared to a normal kidney. Therefore, they are more likely to require surgical intervention. Although there are many methods of intervention, including endovascular treatment for bleeding, surgery, and drainage for urinoma, the management of horseshoe kidney injury requires consideration of the complex anatomy of the vascular and urogenital systems and identification of appropriate treatment modalities.

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