Horseshoe kidney (HSK) is the most common congenital renal fusion anomaly, occurring in approximately 0.25% of the population. It is characterized by the fusion of the lower poles of the kidneys by an isthmus of functional or fibrous renal tissue, and is frequently associated with aberrant vascular supply and altered ureteral anatomy. These anatomical variations can pose significant challenges during colorectal surgery, increasing the risk of inadvertent injury to renal structures. In this article, we report the case of a 25-year-old man with ileocaecal Crohn’s disease, in whom a horseshoe kidney was incidentally discovered on preoperative abdominal CT imaging. The patient underwent ileocaecal resection with ileocolic anastomosis. Intraoperative exploration confirmed the presence of the renal fusion anomaly, which required careful dissection to avoid injury to aberrant vessels and displaced ureters. This case highlights the importance of thorough preoperative imaging and surgical planning in patients with congenital renal malformations undergoing colorectal surgery. Surgeons should be aware of the potential risk for iatrogenic urological and vascular complications in such cases.
Zakaria et al. (Thu,) studied this question.