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Tian T, Chen H, Tang J, Luo H. Prenatal diagnosis of intrathoracic kidney and adrenal gland in left-sided congenital diaphragmatic hernia. Arch Gynecol Obstet 2024; 309:2911-2912. [PMID: 38459998 PMCID: PMC11147819 DOI: 10.1007/s00404-024-07449-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/25/2024] [Indexed: 03/11/2024]
Abstract
A 29-year-old primigravida at 31 weeks of gestation was referred for intrathoracic kidney (ITK). Ultrasound revealed left kidney intrathoracic placement with an anteriorly positioned ectopic adrenal gland. Magnetic resonance imaging confirmed diaphragmatic interruption and colon herniation. A female neonate, delivered at 37 weeks, underwent successful thoracoscopic repair for a left Bochdalek hernia. Despite compression of the left lung, notably optimistic lung-to-head ratio (LHR) values were observed, correlating with favorable outcomes. This case underscores the rare occurrence of ITK, its association with Bochdalek hernia, and the importance of comprehensive prenatal evaluations.
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Affiliation(s)
- Tian Tian
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Huizhu Chen
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Jing Tang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, China
| | - Hong Luo
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China.
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Orlandi G, Toscano P, Gabrielli O, Di Lella E, Lettieri A, Manzo L, Mazzarelli LL, Sica C, Di Meglio L, Di Meglio L, Gulino FA, Incognito GG, Tuscano A, Cianci S, Di Meglio A. Prenatal Diagnosis of an Intrathoracic Left Kidney Associated with Congenital Diaphragmatic Hernia: Case Report and Systematic Review. J Clin Med 2023; 12:3608. [PMID: 37297803 PMCID: PMC10253368 DOI: 10.3390/jcm12113608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/09/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
INTRODUCTION A congenital intrathoracic kidney (ITK) is a rare anomaly that is recognized to have four causes: renal ectopia with an intact diaphragm, diaphragmatic eventration, diaphragmatic hernia, and traumatic diaphragmatic rupture. We report a case of a prenatal-diagnosed ITK related to a congenital diaphragmatic hernia (CDH) and conducted a systematic review of all cases of the prenatal diagnosis of this association. CASE PRESENTATION A fetal ultrasound scan at 22 gestational weeks showed left CDH and ITK, hyperechoic left lung parenchyma, and mediastinal shift. The fetal echocardiography and karyotype were normal. Magnetic resonance imaging at 30 gestational weeks confirmed the ultrasound suspicion of left CDH in association with bowel and left kidney herniation. The fetal growth, amniotic fluid, and Doppler indices remained within the normal range over time. The woman delivered the newborn via an at-term spontaneous vaginal delivery. The newborn was stabilized and underwent non-urgent surgical correction; the postoperative course was uneventful. CONCLUSIONS CDH is the rarest cause of ITK; we found only eleven cases describing this association. The mean gestational age at diagnosis was 29 ± 4 weeks and 4 days. There were seven cases of right and four cases of left CDH. There were associated anomalies in only three fetuses. All women delivered live babies, the herniated kidneys showed no functional damage after their surgical correction, and the prognosis was favorable after surgical repair. The prenatal diagnosis and counseling of this condition are important in planning adequate prenatal and postnatal management in order to improve neonatal outcomes.
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Affiliation(s)
- Giuliana Orlandi
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (G.O.); (P.T.); (E.D.L.); (L.M.); (L.L.M.)
- Diagnostica Ecografica e Prenatale di A. Di Meglio, 80133 Naples, Italy; (A.L.); (C.S.); (A.D.M.)
| | - Paolo Toscano
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (G.O.); (P.T.); (E.D.L.); (L.M.); (L.L.M.)
- Diagnostica Ecografica e Prenatale di A. Di Meglio, 80133 Naples, Italy; (A.L.); (C.S.); (A.D.M.)
| | - Olimpia Gabrielli
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (G.O.); (P.T.); (E.D.L.); (L.M.); (L.L.M.)
- Diagnostica Ecografica e Prenatale di A. Di Meglio, 80133 Naples, Italy; (A.L.); (C.S.); (A.D.M.)
| | - Enrica Di Lella
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (G.O.); (P.T.); (E.D.L.); (L.M.); (L.L.M.)
- Diagnostica Ecografica e Prenatale di A. Di Meglio, 80133 Naples, Italy; (A.L.); (C.S.); (A.D.M.)
| | - Antonia Lettieri
- Diagnostica Ecografica e Prenatale di A. Di Meglio, 80133 Naples, Italy; (A.L.); (C.S.); (A.D.M.)
| | - Luigi Manzo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (G.O.); (P.T.); (E.D.L.); (L.M.); (L.L.M.)
- Diagnostica Ecografica e Prenatale di A. Di Meglio, 80133 Naples, Italy; (A.L.); (C.S.); (A.D.M.)
| | - Laura Letizia Mazzarelli
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (G.O.); (P.T.); (E.D.L.); (L.M.); (L.L.M.)
- Diagnostica Ecografica e Prenatale di A. Di Meglio, 80133 Naples, Italy; (A.L.); (C.S.); (A.D.M.)
| | - Carmine Sica
- Diagnostica Ecografica e Prenatale di A. Di Meglio, 80133 Naples, Italy; (A.L.); (C.S.); (A.D.M.)
| | - Letizia Di Meglio
- Radiology Department, School of Medicine, University of Milan, 20133 Milan, Italy;
| | - Lavinia Di Meglio
- Pediatric Department, Bambino Gesù Children’s Research Hospital IRCCS, 00165 Rome, Italy;
| | - Ferdinando Antonio Gulino
- Department of Obstetrics and Gynaecology, Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Garibaldi Nesima, 95124 Catania, Italy
| | - Giosuè Giordano Incognito
- Department of General Surgery and Medical Surgical Specialties, University of Catania, 95123 Catania, Italy (A.T.)
| | - Attilio Tuscano
- Department of General Surgery and Medical Surgical Specialties, University of Catania, 95123 Catania, Italy (A.T.)
| | - Stefano Cianci
- Department of Human Pathology of Adult and Childhood “G. Barresi”, University of Messina, 98121 Messina, Italy;
| | - Aniello Di Meglio
- Diagnostica Ecografica e Prenatale di A. Di Meglio, 80133 Naples, Italy; (A.L.); (C.S.); (A.D.M.)
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