Traumatic Renal Injury in A Horseshoe Kidney: Case Report and Literature Review

Main Article Content

Dorantes-Carrillo, Luis Alberto
Millán-Flores, Ricardo Alexander
Gómez-Lara, Miguel Humberto
Narváez-Morales, José Antonio
Melendez-Bautista, Elisael
García González Marcos Andreas

Abstract

BACKGROUND: Horseshoe kidney (HSK) is the most common congenital renal fusion anomaly, with an annual incidence of 1 case per 500 newborns. While the exact etiologic mechanism remains unknown, its presence predisposes the kidney to traumatic injury; therefore, a proper diagnostic approach is essential for selecting the appropriate definitive treatment.


OBJECTIVE: To describe a case of renal trauma in a patient with a horseshoe kidney.


CLINICAL CASE: A 30-year-old male patient was admitted to the emergency department after being struck by a motor vehicle, with unknown trauma kinematics. The approach was conducted according to the Advanced Trauma Life Support (ATLS) guidelines. Computed tomography (CT) documented bilateral renal trauma in a patient with a horseshoe kidney.


CONCLUSIONS: The prevalence of renal trauma in patients with horseshoe kidneys is limited due to the low prevalence of this anomaly. Consequently, accurate radiological diagnosis and appropriate clinical monitoring are vital when making correct therapeutic decisions.

Article Details

How to Cite
Luis Alberto, Dorantes-Carrillo, Millán-Flores, Ricardo Alexander, Gómez-Lara, Miguel Humberto, Narváez-Morales, José Antonio, Melendez-Bautista, Elisael, and García González Marcos Andreas. 2026. “Traumatic Renal Injury in A Horseshoe Kidney: Case Report and Literature Review”. International Journal of Medical Science and Clinical Research Studies 6 (03):446-56. https://doi.org/10.47191/ijmscrs/v6-i3-01.
Section
Articles

References

I. Humphries, A., Speroni, S., Eden, K., Nolan, M., Gilbert, C., & McNamara, J. (2023). Horseshoe kidney: Morphologic features, embryologic and genetic etiologies, and surgical implications. Clinical Anatomy, 36(8), 1081–1088. https://doi.org/10.1002/ca.24018

II. Nechita, O.-C., Badescu, D., Popescu, R.-I., Rascu, S., Petca, R.-C., Aurelian, J., Constantin, T., Toma, C.-V., Jinga, V., & Geavlete, B. (2025). Reviewing the complexities of horseshoe kidney: insights into embryogenesis and surgical considerations. Journal of Medicine and Life, 18(1), 10–19. https://doi.org/10.25122/jml-2024-0325

III. Natsis K, Piagkou M, Skotsimara A, Protogerou V, Tsitouridis I, Skandalakis P. Horseshoe kidney: a review of anatomy and pathology. Surgical and radiologic anatomy:SRA. 2014 Aug:36(6):517-26. doi: 10.1007/s00276-013-1229-7. Epub 2013 Nov 1 [PubMed PMID: 24178305]

IV. Kumar G, Stern J, & Leslie SW. (2025). Horseshoe Kidney. In StatPearls. StatPearls Publishing. [PubMed PMID: 28613757]

V. Murugapoopathy, V., & Gupta, I. R. (2020). A primer on congenital anomalies of the kidneys and urinary tracts (CAKUT). In Clinical Journal of the American Society of Nephrology (Vol. 15, Issue 5, pp. 723–731). American Society of Nephrology. https://doi.org/10.2215/CJN.12581019

VI. Majos, M., Polguj, M., Szemraj-Rogucka, Z., Arazińska, A., & Stefańczyk, L. (2018). The level of origin of renal arteries in horseshoe kidney vs. in separated kidneys: CT-based study. Surgical and Radiologic Anatomy, 40(10), 1185–1191. https://doi.org/10.1007/s00276-018-2071-8

VII. Pal, A., & Reidy, K. J. (2017). Genetic syndromes affecting kidney development. In Results and Problems in Cell Differentiation (Vol. 60, pp. 257–279). Springer Verlag. https://doi.org/10.1007/978-3-319-51436-9_10

VIII. Je, B. K., Kyung, H. K., & Horn, P. S. (2015). Incidence and spectrum of renal complications and extrarenal diseases and syndromes in 380 children and young adults with horseshoe kidney. American Journal of Roentgenology, 205(6), 1306–1314. https://doi.org/10.2214/AJR.15.14625

IX. Pawar, A. S., Thongprayoon, C., Cheungpasitporn, W., Sakhuja, A., Mao, M. A., & Erickson, S. B. (2018). Incidence and characteristics of kidney stones in patients with horseshoe kidney: A systematic review and meta-analysis. Urology Annals, 10(1), 87–93. https://doi.org/10.4103/UA.UA_76_17

X. Pollak, M. R., & Friedman, D. J. (2020). The genetic architecture of kidney disease. Clinical Journal of the American Society of Nephrology, 15(2), 268–275. https://doi.org/10.2215/CJN.09340819

XI. Tae, B. S., Jang, H. A., Yu, J., Oh, K. J., Moon, K. H., & Park, J. Y. (2022). Epidemiology and Management Trend of Renal Trauma: Results of a Nationwide Population-Based Study. Journal of Korean Medical Science, 37(47). https://doi.org/10.3346/jkms.2022.37.e333

XII. Erlich, T., & Kitrey, N. D. (2018). Renal trauma: the current best practice. In Therapeutic Advances in Urology (Vol. 10, Issue 10, pp. 295–303). SAGE Publications Inc. https://doi.org/10.1177/1756287218785828

XIII. Coccolini, F., Moore, E. E., Kluger, Y., Biffl, W., Leppaniemi, A., Matsumura, Y., Kim, F., Peitzman, A. B., Fraga, G. P., Sartelli, M., Ansaloni, L., Augustin, G., Kirkpatrick, A., Abu-Zidan, F., Wani, I., Weber, D., Pikoulis, E., Larrea, M., Arvieux, C., Ivatury, R. (2019). Kidney and uro-trauma: WSES-AAST guidelines. In World Journal of Emergency Surgery (Vol. 14, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s13017-019-0274-x

XIV. Saadi, A., Maatougui, J., Hermi, A., Mokadem, S., Boussaffa, H., Zaghbib, S., Bellali, M., Allouche, M., Jrad, M., Ayed, H., Bouzouita, A., Derouiche, A., Chakroun, M., & ben Slama, M. R. (2023). Management of blunt renal trauma on pre-existing diseased kidneys: a cross-sectional study. Annals of Medicine & Surgery, 85(6), 2432–2436. https://doi.org/10.1097/ms9.0000000000000594incgoogooglgoo

XV. Prieto-Chaparro L, Silmi-Moyano A, Delgado-Martín JA, Paez-Borda A, Blázquez-Izquierdo J, Salinas-Casado J, Begara-Morillas F, Resel-Estevez L. Traumatismo renal sobre riñón patológico. Incidencia, manejo y resultados de tratamiento [Renal injury on a pathological kidney. Incidence, management, and results of treatment]. Arch Esp Urol. 1992 Jun;45(5):407-13. Spanish. PMID: 1324652.

XVI. Bahloul, A., Krid, M., Trifa, M., Mosbah, A. T., & Mhiri, M. N. (1997). Les contusions sur rein pathologique. Etude rétrospective, à propos de 34 cas [Contusions to the pathologic kidney. A retrospective study, apropos of 34 cases]. Annales d'urologie, 31(5), 253–258. [PubMed PMID: 9480628]

XVII. Schmidlin, F. R., Iselin, C. E., Naimi, A., Rohner, S., Borst, F., Farshad, M., Niederer, P., & Graber, P. (1998). The Higher Injury Risk of Abnormal Kidneys in Blunt Renal Trauma. Scand J Urol Nephrol 32: 388–392, 1998.https://doi.org/10.1080/003655998750015151

XVIII. Giannopoulos, A., Serafetinides, E., Alamanis, C., & Constantinides, C. (1999). Lésions urogénitales diagnostiquées par hasard au cours du bilan pour des contusions fermées rénales. Progrès en Urologie (1999), 9, 464-469. [PubMed PMID: 10434318]

XIX. Krutsri, C., Singhatas, P., Sumpritpradit, P., Chaijareenont, C., Viseshsindh, W., Thampongsa, T., & Choikrua, P. (2020). Traumatic Blunt Force Renal Injury in a Diseased Horseshoe Kidney with Successful Embolization to Treat Active Bleeding: A Case Report and Literature Review. Case Reports in Urology, 2020, 1–6. https://doi.org/10.1155/2020/8897208

XX. Cortese, F., Fransvea, P., Marcello, R., Saputelli, A., Lepre, L., Gioffrè, A., & Sganga, G. (2017). Challenging case of horseshoe kidney double fracture. International Journal of Surgery Case Reports, 41, 158–161. https://doi.org/10.1016/j.ijscr.2017.08.070

XXI. Molina Escudero, R., Cancho Gil, M. J., Husillos Alonso, A., Lledó García, E., Herranz Amo, F., Ogaya Piniés, G., Ramón Botella, E., Simó, G., Navas Martínez, M. C., & Hernández Fernández, C. (2012). Traumatic rupture of horseshoe kidney. Urologia Internationalis, 88(1), 112–114. https://doi.org/10.1159/000330800

XXII. Paragi, P. R., Go, P. H., Klaassen, Z., & Ingram, M. (2011). Trauma to a horseshoe kidney: Case report and review of the literature. UroToday International Journal, 4(4). https://doi.org/10.3834/uij.1944-5784.2011.08.03

XXIII. Lee, Y. J., Oh, S. N., Rha, S. E., & Byun, J. Y. (2007). Renal Trauma. In Radiologic Clinics of North America (Vol. 45, Issue 3, pp. 581–592). https://doi.org/10.1016/j.rcl.2007.04.004

XXIV. Jalli, R., Kamalzadeh, N., Lotfi, M., Farahangiz, S., Salehipour, M., Üniversitesi, S., Fakültesi, T., Dal›, R. A., Dal›, T. A., & Dal›, Ü. A. (2009). Accuracy of sonography in detection of renal injuries caused by blunt abdominal trauma: a prospective study [Künt abdominal travmanin neden olduğu böbrek yaralanmalarinin saptanmasında sonografinin doğruluğu: Prospektif bir çalışma. Ulus Travma Acil Cerrahi Derg. 2009;15(1):23-27. [PubMed PMID: 19130335]

XXV. Sato, M., & Yoshii, H. (2004). Reevaluation of Ultrasonography for Solid-Organ Injury in Blunt Abdominal Trauma.J Ultrasound Med 2004; 23:1583–1596. https://doi:10.7863/jum.2004.23.12.1583

XXVI. Bonatti, M., Lombardo, F., Vezzali, N., Zamboni, G., Ferro, F., Pernter, P., Pycha, A., & Bonatti, G. (2015). MDCT of blunt renal trauma: imaging findings and therapeutic implications. In Insights into Imaging (Vol. 6, Issue 2, pp. 261–272). Springer Verlag. https://doi.org/10.1007/s13244-015-0385-1

XXVII. Osman, N. M. M., Eissawy, M. G., & Mohamed, A. M. (2016). The role of multi-detector computed tomography with 3D images in evaluation and grading of renal trauma. Egyptian Journal of Radiology and Nuclear Medicine, 47(1), 305–317. https://doi.org/10.1016/j.ejrnm.2015.12.003

XXVIII. Shen, X., Zhou, Y., Shi, X., Zhang, S., Ding, S., Ni, L., Dou, X., & Chen, L. (2024). The application of deep learning in abdominal trauma diagnosis by CT imaging. World Journal of Emergency Surgery, 19(1). https://doi.org/10.1186/s13017-024-00546-7

XXIX. Kautza, B., Zuckerbraun, B., & Peitzman, A. B. (2015). “Management of blunt renal injury: what is new?” In European Journal of Trauma and Emergency Surgery (Vol. 41, Issue 3, pp. 251–258). Springer Berlin. https://doi.org/10.1007/s00068-015-0516-x

XXX. Santo, I. D. de O., Sailer, A., Solomon, N., Borse, R., Cavallo, J., Teitelbaum, J., Chong, S., Roberge, E. A., & Revzin, M. v. (2023). Grading Abdominal Trauma: Changes in and Implications of the Revised 2018 AAST-OIS for the Spleen, Liver, and Kidney. Radiographics, 43(9). https://doi.org/10.1148/rg.230040

XXXI. Aziz, H. A., Bugaev, N., Baltazar, G., Brown, Z., Haines, K., Gupta, S., Yeung, L., Posluszny, J., Como, J., Freeman, J., & Kasotakis, G. (2023). Management of adult renal trauma: a practice management guideline from the eastern association for the surgery of trauma. BMC Surgery, 23(1). https://doi.org/10.1186/s12893-023-01914-x

XXXII. Mingoli, A., Torre, M. la, Migliori, E., Cirillo, B., Zambon, M., Sapienza, P., & Brachini, G. (2017). Operative and nonoperative management for renal trauma: Comparison of outcomes. A systematic review and meta-analysis. In Therapeutics and Clinical Risk Management (Vol. 13, pp. 1127–1138). Dove Medical Press Ltd. https://doi.org/10.2147/TCRM.S139194

XXXIII. Sujenthiran, A., Elshout, P. J., Veskimae, E., MacLennan, S., Yuan, Y., Serafetinidis, E., Sharma, D. M., Kitrey, N. D., Djakovic, N., Lumen, N., Kuehhas, F. E., & Summerton, D. J. (2019). Is Nonoperative Management the Best First-line Option for High-grade Renal trauma? A Systematic Review. In European Urology Focus (Vol. 5, Issue 2, pp. 290–300). Elsevier B.V. https://doi.org/10.1016/j.euf.2017.04.011

XXXIV. Lanchon, C., Fiard, G., Arnoux, V., Descotes, J. L., Rambeaud, J. J., Terrier, N., Boillot, B., Thuillier, C., Poncet, D., & Long, J. A. (2016). High Grade Blunt Renal Trauma: Predictors of Surgery and Long-Term Outcomes of Conservative Management. A Prospective Single Center Study. Journal of Urology, 195(1), 106–111. https://doi.org/10.1016/j.juro.2015.07.100

XXXV. Yuan, K. C., Wong, Y. C., Lin, B. C., Kang, S. C., Liu, E. H., & Hsu, Y. P. (2012). Negative catheter angiography after vascular contrast extravasations on computed tomography in blunt torso trauma: an experience review of a clinical dilemma. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 20. https://doi.org/10.1186/1757-7241-20-46

XXXVI. Vozianov, S., Sabadash, M., & Shulyak, A. (2015). Experience of renal artery embolization in patients with blunt kidney trauma. Central European Journal of Urology, 68(4), 471–477. https://doi.org/10.5173/ceju.2015.491

XXXVII. Hagiwara, A., Sakaki, S., Goto, H., Takenega, K., Fukushima, H., Matuda, H., & Shimazaki, S. (2001). The Role of Interventional Radiology in the Management of Blunt Renal Injury: A Practical Protocol.

XXXVIII. Antunes-Lopes, T., Pinto, R., Morgado, P., Madaleno, P., Silva, J., Silva, C., & Cruz, F. (2014). Intrarenal artery pseudoaneurysm after blunt abdominal trauma: A case report of successful superselective angioembolization. Research and Reports in Urology, 6(1), 17–20. https://doi.org/10.2147/RRU.S58291

XXXIX. Lin, W. C., Lin, C. H., Chen, J. H., Chen, Y. F., Chang, C. H., Wu, S. C., Hsu, C. N., Lin, C. H., & Ho, Y. J. (2013). Computed tomographic imaging in determining the need of embolization for high-grade blunt renal injury. Journal of Trauma and Acute Care Surgery, 74(1), 230–235. https://doi.org/10.1097/TA.0b013e318270e156

XL. Becker, A., Baig, M., & Becker, A. (2010). Conservative management of a grade v injury to an ectopic pelvic kidney following blunt trauma to the lower abdomen: A case report. Journal of Medical Case Reports, 4. https://doi.org/10.1186/1752-1947-4-224