Incidentally detected pancake kidney:case report of an extremely rare congenital anomaly.

Abstract Background:Congenital anomalies of urinary system are very common and have extremely varied presentation. Among them most rarely found structural anomaly is the pancake kidney. When both kidneys are fused along their medial surfaces to form a round shaped single renal mass is termed as Pancake kidney. In this case report, a pancake kidney was incidentally detected in a girl. The majority of subjects who have pancake kidney are usually symptom less but surgeons should be aware of coexisting malformation of other organs and its potential risk of developing malignancy.Case presentation:A 12-year-old young lady attended out-patient department with mild dull aching lower abdominal pain and dysuria. She had no history of fever, haematuria, menstrual abnormality, pelvic inflammatory disease or trauma. Urine examination showed traces of albumin and 10-12 pus cells/ HPF. She had normal kidney function test and digital X-ray of KUB region. A USG of the whole abdomen showed normal intra-abdominal organs except empty bilateral renal fossa. The Multi-Detector Computed Tomography(MDCT) scan of the whole abdomen revealed one round shaped mass measuring approximately 9 cm(vertical) X 10 cm(horizontal), in the pelvic cavity. That mass was finally identified as a pancake kidney. She was prescribed antibiotics based on urine culture, and sensitivity test that cured her symptoms. She was advised to follow-up regularly in Out-Patient Department to evaluate her kidney function and to rule out any neoplastic change. Conclusions: This condition can be managed conservatively, if the subject remains symptom less, by regular monitoring of renal function. Surgeon should remain alert for the development of infections, any obstructive manifestations leading to calculus formation and any malignant changes. The person should be careful in avoiding trauma to low-lying pelvic kidney. Extensive surgeries should be avoided and only selective procedures should be done so that the patient may lead a normal lifestyle.