An incidentally diagnosed Horseshoe kidney with bilateral normally located kidneys and dilated left renal vein not associated with nutcracker syndrome in a 23-year-old during evaluation for the cause of recurrent right upper quadrant abdominal pain diagnosed as calculus cholecystitis on ultrasound is presented.
Contrast-enhanced CT showed bilateral single renal arteries. The left renal artery was larger and it arises 45mm lower than the right renal artery. Left renal vein diameter (15.0mm) to right renal vein diameter (7.2mm) ratio of 2:1 is an extremely rare association amongst reported cases in the English literature. Though not unmindful of the limitations of concluding based on a single case report, we assumed there may exist a functional dominance of the left kidney over the right in our patient because both the left renal artery and veins were larger than the right. Dynamic functional studies will be required to corroborate this assertion.
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