Ectopic kidney

　　The occurrence of ectopic kidney is caused by the rise of the kidney in the fourth to eighth week of fetal development. The specific causes and mechanisms are described as follows.

　　1. Etiology

　　Under normal circumstances, by the end of the eighth week of fetal development, both kidneys have reached the level of the second lumbar vertebra. The formation of ectopic kidneys occurs during the rise of the kidney in the fourth to eighth week of fetal development. Due to factors such as impaired growth of the ureteral bud, abnormal blood supply, or excessive growth of the Wolffian duct, the kidney rise stops, accelerates, or misrises to the opposite side, resulting in ectopic kidney or poor rotation.

　　2. Pathogenesis

　　Ectopic kidneys differ from ptosis kidneys, the latter initially in the normal position, with normal vessels and ureters. Ectopic kidneys are usually smaller, about 60% located in the pelvis, with shorter ureters, and the supplying blood vessels come from the lower segment of the aorta and the main branches of the pelvic vessels, and they are often branching. If the kidney continues to rise in the eighth week of embryogenesis, part of the kidney or all of the kidney passes through the diaphragm into the posterior mediastinum, forming intrathoracic kidney, accounting for about 5%, the ureter is elongated, but the blood supply is normal, and there is no poor rotation of the kidney. Cross-ectopic kidneys can be divided into fused and non-fused types, and the ureters often enter the bladder through the normal path and open normally in the trigone.

　　Ectopic kidneys are usually underdeveloped, with short ureters, poor rotation, and may have wandering blood vessels, often leading to hydronephrosis. When secondary infection, stones, or compression of adjacent organs occurs, it can cause clinical symptoms. Common symptoms are back pain and abdominal pain, and the patient is diagnosed with an ectopic kidney due to consultation. Many patients have no obvious clinical symptoms and are accidentally discovered during other examinations.

　　15% to 45% of patients with pelvic ectopic kidney have associated reproductive organ malformations such as bicornuate uterus, unicornuate uterus with a残角子宫, incomplete development of the uterus and vagina, double vagina, etc., in males, cryptorchidism, double urethra, hypospadias, etc.

　　An ectopic kidney usually has no symptoms, and it is often discovered by surprise during a physical examination. The specific clinical manifestations are described as follows.

　　1. Usually asymptomatic, often discovered by instruments during physical examination.

　　2. Cystoscopy revealed an asymmetric trigone of the bladder, with one ureteral orifice absent.

　　3. A solitary kidney is usually larger than a normal kidney.

　　4. A common condition is the underdevelopment or absence of one kidney. Underdeveloped kidneys can cause back pain and hypertension. Venous urography shows that the shape and pelvis of the affected kidney are smaller and the shadow is blurred. It is often discovered by accident.

　　There is currently no relevant information on the prevention of ectopic kidneys. If patients have no symptoms or obvious compression symptoms, no special treatment is needed. When complications such as infection occur, antibacterial drugs can be used; when complications such as severe hydronephrosis or pyonephrosis occur, surgical treatment is required. In daily life, it is advisable to actively participate in physical exercise, such as running and jogging, which can enhance personal physique and improve the body's immunity to diseases. Regularly participate in health physical examinations organized by the unit, and seek medical attention in a timely manner when the condition is found.

　　Common symptoms of patients with ectopic kidneys are back pain and abdominal pain, which lead patients to seek medical attention. Many patients have no obvious clinical symptoms and are found incidentally during examinations for other reasons. Some patients can palpate a mass in the abdominal examination, and have discomfort when pressed. Generally, venous pyelography or enhanced CT examination can be used to confirm the diagnosis. Renal function and biochemical tests can also be performed by ultrasound, which is not as accurate as CT.

　　The diet of patients with ectopic kidneys should be light, and they should avoid overeating and other issues. The specific dietary precautions are described as follows.

　　Patients with ectopic kidneys should eat light, easily digestible food, consume fresh vegetables and a moderate amount of fruit, and drink water appropriately. Pay attention to a balanced diet and nutrition.

　　Patients with ectopic kidneys should avoid overeating, eating unclean food. Avoid seafood, beef, mutton, spicy and刺激性 food; Avoid alcohol and all irritants, such as: five-spice powder, coffee, coriander, etc.; Avoid all tonics, tonics, and easy-to-heat food, such as: chili, ginger, chocolate, etc.

　　When treating ectopic kidneys, it is first necessary to determine whether it is a solitary kidney and whether the renal function is impaired. The treatment should be adopted according to the above conditions, and the specific treatment methods are described as follows.

　　Patients without complications do not require treatment.

　　If a solitary kidney has congenital lesions that require surgical treatment, sufficient kidney tissue and renal function should be preserved as much as possible, and solitary kidneys should not be mistakenly removed.

　　If the renal function of a solitary kidney is severely impaired, dialysis treatment or kidney transplantation should be performed.

　　When dealing with kidney diseases, it is necessary to first determine whether the contralateral kidney is underdeveloped or absent, especially in cases of trauma, to avoid blindly removing congenital solitary kidneys. If found, inform the patient to pay attention to protection as much as possible to avoid injury.