Traumatic rupture of horseshoe kidney with partial ureteral duplication associated with supernumerary kidney.

The first reported case of traumatic rupture of a horseshoe kidney with partial ureteral duplication and an associated supernumerary kidney is presented. A review of the incidence, hypothesis of embryogenesis, associated anomalous development, and acute surgical management of this unique renal anomaly is provided.

Circumflex retroesophageal right aortic arch simulating mediastinal tumor or dissecting aneurysm.

The authors present three cases of circumflex right aortic arch, a retroesophageal arch in which the aorta crosses from right to left behind the esophagus to descend on the left side. The findings on the frontal chest films resembled those of a left arch with mediastinal widening, simulating a mass. Aortography revealed four-vessel branching of the arch vessels, typical of right aortic arch with aberrant left subclavian artery. Computed tomography and barium studies of the esophagus demonstrated the retroesophageal course of the aorta. In two patients, obstruction of the thoracic portion of the left subclavian artery resulted in differences in blood pressure and pulse between the arms, supporting the clinical impression of dissecting aortic aneurysm.

Epinephrine renal venography in severe inflammatory disease of the kidney.

In a comparative study of the diagnostic value of epinephrine renal venography (ERV) and angiography in eight patients with severe inflammatory disease of the kidneys, the spectrum of abnormalities exhibited by ERV was more striking than the angiographic findings. Complete disorganization of the renal venous architecture with linear streaking of contrast agent is a sign of renal inflammatory disease. ERV is a useful adjunctive diagnostic procedure in cases of a nonfunctioning kidney.