A two years old male child, presented with high grade fever with a large lump in the right and central part of abdomen since 10 days. CT scan showed presence of horseshoe kidney with gross pyonephrosis of the right renal moiety.
Initially, a nephrostomy tube was placed under USG guidance which drained about 250 ml of thick pus. As the fever subsided, DTPA scan was done with confirmed non-functioning of the right renal moiety of the horse shoe kidney probably due to PUJ obstruction.
Patient was then planned for definitive surgery. A detailed Renal CT angio with 3D reconstruction was done to visualize all the vessels supplying the right renal moiety, as horseshoe kidneys as known to have atypical and aberrant vascularity.
Patient was then taken up for definitive surgery and nephrectomy of the right renal moiety of the horseshoe kidney was done. Patient was discharged uneventfully on 5th postoperative day.
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