Pan Cake Kidney-A Rare Congenital Renal Fusion Anomaly and Renal Ectopia

Background: Pan cake kidney is renal ectopia with rarest fusion anomaly with multiple accessory renal arteries. Pan cake Kidney is formed due to extensive fusion of both kidneys upper poles and lower poles along their medial borders. It is also called as shield kidney and Dough nut Kidney. It is a rarest fusion Anomaly of kidneys very few cases were reported all over the world. During routine dissection found Pan cake kidney in a female cadaver in anterior midline in front of L3,L4,L5 and upper part of sacrum in lumbosacral region of female Pelvis. A study on Renal fusion Anomalies and Renal ectopia. Material and Methods: Routine cadaveric dissection as a part of undergraduate MBBS Teaching curriculum. Total 51 kidneys were studied in 26 Cadavers 18 Kidneys were studied in 9 Cadavers in Government Medical college, Suryapet. 8 Kidneys were studied in 4 Cadavers in Government Medical college, Bhadradri Kothagudem 24 kidneys were studied in 12 cadavers,1Pan cake kidney in female cadaver in Kakatiya medical Medical College, Warangal. Results: Kidney shape-Bean shaped -50(98.32%), Pan cake kidney-1(1.96%), Location-Extent of Left kidney-FromT12-L2 -25(96.15%), Extent of Right kidney L1-L3 -25(96.15%), Renal ectopia-Failure of ascent of both kidneys-pelvic kidneys-1(1.96%). Fusion Anomalies-Pan cake kidney-seen in midline anterior to mid L3,L4,L5 and upper part of sacrum-1(1.96%). Origin of single right and left renal arteries-Arise from abdominal aorta below level of superior mesenteric arteries-50(98.32%), Multiple accessory renal arteries-Arise from abdominal aorta below level of inferior mesenteric artery-1(1.96%). Conclusion: Variation in shape and location of kidney found during cadaveric study, reminds clinical importance of diagnostic procedures such as excretory, retrograde urograms, Ultrasound exam of abdomen.

Keywords: Pancake kidney, Shield Kidney, Doughnut Kidney.