Anomalous or faulty rotation of the kidney, a term applied to congenital variation in position, is seldom the cause in itself of renal functional disturbance.1 However, in conjunction with intrinsic deformities of renal mass, such as horseshoe kidney, or with some of the common anatomic aberrations of vascular supply,2 acute or chronic interference with renal function may occur.3 Similarly, renal torsion, an acquired malrotation, such as results from growth of a retroperitoneal tumor, may impair function of the kidney. These rotational anomalies are clinically distinct from abnormal renal mobility for which nephropexy is advocated to relieve Dietl's crises4 associated with mechanical obstruction.5
The renal pelvis faces anteriorly at the end of the first month of embryonic life. In the sixth week, the kidney derives blood supply from the adjacent area of the aorta, which will eventually be the aortic bifurcation. New arteries are acquired stepwise
Abrams AL, Finkle AL. REVERSIBLE SUPPRESSED FUNCTION IN UNILATERAL RENAL MALROTATION. JAMA. 1957;163(8):641–644. doi:10.1001/jama.1957.82970430001010
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