—Herbst1 states that observations for a period of six years have resulted in an experience which indicates that the posterior location of the renal pelvis is important in the case of patients who have ptotic kidneys. Every patient operated on during the six year period had this condition.In 13 cases nephrectomy was performed, and in 2 cases resection of the lower pole of the kidney was done. Diagnostic features, from a roentgenologic standpoint, were the lateral location of the course of the ureter as compared with the medial border of the renal pelvis and the gun barrel effect of the ureter branching off posteriorly. Posterior location of the renal pelvis is, in the opinion of Herbst, the result of a congenital malformation. The ureteral bud fuses in such a way that even though the kidney itself may rotate normally the renal pelvis and ureter come out
SCHOLL AJ, HINMAN F, CROWLEY E, et al. REVIEW OF UROLOGIC SURGERY. Arch Surg. 1950;60(1):182–202. doi:10.1001/archsurg.1950.01250010198019
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