—Jacobs1 stated that in horseshoe kidney either the upper or lower poles of both kidneys fuse, the latter condition being more common. The parenchyma of the fused part which lies anterior to the great vessels varies in amount. The ureters, usually two, arise from separate pelves and pass anterior to the isthmus, but because of their unusual position and curvature the kidneys are predisposed to obstruction, infection and stone.Jacobs reported two cases of horseshoe kidney. In the first case, albuminuria led to a roentgenographic examination and the discovery of calculus. Bilateral pyelographic examination disclosed the lateral position of the ureteropelvic juncture. The isthmus was divided at operation, but a urinary fistula persisted due to cutting across a calyx in the resected portion of the isthmus. In the second case, there was backache and hematuria, with hydronephrosis on the left side and the calices directed mesially. The
SCHOLL AJ, JUDD ES, KEYSER LD, VERBRUGGE J, KUTZMANN AA, HEPLER AB. A REVIEW OF UROLOGIC SURGERY. Arch Surg. 1932;24(3):516–530. doi:10.1001/archsurg.1932.01160150179009
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