International Journal of Science and Research (IJSR)
ISSN: 2319-7064
SJIF (2020): 7.803
A Case Report of Right Supernumerary Kidney
Dr. Elizabeth Kurian1, Dr. Jijo Joseph2, Dr. Arun Prasad3, Dr. Rajeevanand4, Dr. Kishore S Dharan5
1
Radiology, MOSC Medical College, Kochi
Corresponding Author Email: el212el[at]gmail.com
2, 3, 4, 5
Radiology, MOSC Medical College, Kochi
1. Introduction
The patient was managed symptomatically for the
Supernumerary kidney is a rare congenital anomaly. It is abdominal pain and was advised to be on regular follow-up
described as an additional kidney with it’s own capsule and
blood supply that is not fused with the ipsilateral 3. Discussion
kidney(unlike in the more common duplex kidney).The
blood supply of supernumerary kidney is highly variable and Supernumerary kidney is a rare entity, with fewer than 100
the ureters tend to join with the ureter of the ipsilateral cases reported in literature(1,2).
kidney. The presence of a supernumerary kidney is often The embryological basis for the occurrence of a
associated with increased risk of pyelonephritis,urolithiasis supernumerary kidney has not been fully elucidated. One of
and hydronephrosis the main theories is that there is complete duplication of the
ureteral bud, with independent penetration into the
The aim of this case report is to document this rare metanephric blastema, which develops and divides into two
congenital anomaly kidneys. Another theory is that there are two independent
ureteral buds that penetrate the metanephric blastema, which
2. Case Report then divides. It is believed that a supernumerary kidney with
a ureter that has its own insertion site in the bladder reflects
A 16 year old female presented to the emergency department an initial division of the mesenchyma before insertion and
with complaints of abdominal pain and was evaluated for the branching of the ureteral bud. A supernumerary kidney with
same. Lab reports were unremarkable.There was no history a ureter that fuses with that of the normal kidney probably
of repeated urinary tract infections. reflects late division of the metanephric mesenchyma (1).
Ultrasonography done showed two kidneys on the right side Supernumerary kidney can range from a small lymph node
with right upper kidney measuring 6.4 x 2.6 cm and right like mass to a normal sized kidney, however they usually
lower kidney measuring 8.1 x 3.3 cm. Right lower kidney have few calyces.
shows mild anterior rotation. Echoes and contour are normal
.No hydronephrosis. Single left kidney noted. They are equally distributed on both sides and
supernumerary kidneys usually follows Weigert Meyer law
She was further evaluated with computed tomography with a as in most fully documented cases of double ureters
urography phase
The location of the supernumerary kidneys is usually caudal
One the CT urogram two kidneys were noted on right side. to the main kidney but in 25% of cases it is cephaled, but
Upper kidney appeared normal in position and orientation caudal to the adrenals. It is usually seen at the level of
and measured 6.6 x 2.9cm,which is supplied by a single lumbar vertebrae and sometimes in iliac region or in front of
branch from the aorta and venous drainage into IVC. Lower the sacral promontory.
kidney measured 8.1 x 3.7 cm and appeared to be reverse
rotated with hilum facing laterally. It was seen to be The blood supply is highly variable, usually it is an
receiving two branches from aorta and venous drainage into independent branch arising from the aorta and venous
IVC. Both kidneys showed normal enhancement and prompt drainage is into IVC(3).
contrast excretion. The ureter of the upper kidney is seen to
be medially displaced by the lower kidney. 4. Conclusion
Ureter of the lower kidney was seen to arise laterally and Supernumerary kidneys are extremely rare and the case
coursed downwards and medially .Both the ureters on right reported above is unique in certain aspects. One, the
side were seen till the level of iliac vessel, beyond which it supernumerary kidney is located on the right side. Two, the
was not opacified in delayed images. supernumerary kidney described in this case has almost
equal number of calyces as the normal kidney. Three, there
To further evaluate the course of ureters, a correlative MR is reverse rotation of the supernumerary kidney with hilum
urography was done which showed probable fusion of the facing laterally.
two right ureters at this level (level of iliac vessels) with
single ureter coursing downwards into the urinary bladder. References
The insertion of the ureter appears to be in normal position
Volume 10 Issue 8, August 2021
www.ijsr.net
Licensed Under Creative Commons Attribution CC BY
Paper ID: SR21817172025 DOI: 10.21275/SR21817172025 888
International Journal of Science and Research (IJSR)
ISSN: 2319-7064
SJIF (2020): 7.803
[1] Nouira K, Menif E, Nouira Y, Baccar S, Salem A, [3] Jamshidian H, Tavakoli K, Salahshour F, Nabighadim
Horchani A, Slim R. Rein surnuméraire: à propos un A, Amini E. Supernumerary Kidney Associated with
cas [Supernumerary kidney: a case report]. Tunis Med. Horseshoe Malformation: A Case Report and Review
2002 Mar;80(3):152-4. French. PMID: 12355644. of Literature. Urology Case Reports. 2017 Feb;11:57-
[2] Andersen NL, Jensen R, Graumann O Incidental 59. DOI: 10.1016/j.eucr.2016.11.010. PMID:
finding of a right-sided supernumerary kidney BMJ 28180090; PMCID: PMC5292652.
Case Reports CP 2020;13:e239968.
Figure 1: Ultrasonography and Colour Doppler Images of Right Supernumerary Kidney
Volume 10 Issue 8, August 2021
www.ijsr.net
Licensed Under Creative Commons Attribution CC BY
Paper ID: SR21817172025 DOI: 10.21275/SR21817172025 889
International Journal of Science and Research (IJSR)
ISSN: 2319-7064
SJIF (2020): 7.803
Figure 3: 3 D Reconstrucion Image of Right Supernumerary Kidney with Separate Arterial Supply
Figure 2: CT Axial Images of Right Supernumerary Kidney
Volume 10 Issue 8, August 2021
www.ijsr.net
Licensed Under Creative Commons Attribution CC BY
Paper ID: SR21817172025 DOI: 10.21275/SR21817172025 890
