Crossed fused renal ectopia: Challenges in diagnosis and management
A 5-year-old boy presented after having undergone a right transverse colostomy at birth, in another hospital, for supralevator anorectal malformation. The anorectal malformation was treated with posterior sagittal anorectoplasty and subsequent colostomy closure. However, investigations for associated problems in anorectal malformation, the ultrasonography, micturating cystourethrography, radionuclide renal dynamic scan and magnetic resonance urography revealed an empty right renal fossa, right crossed renal ectopia fused with left kidney, bilateral grade IV vesicoureteral reflux with normally functioning kidneys and bilateral ectopic vas deferens opening in the urinary bladder in respective paraureteric location. Both the ectopic vas deferens were disconnected from the bladder and ligated. The ureters were reimplanted by the cross trigonal (Cohen's) technique. Postoperatively, the patient is continent for stools, the kidneys show normal function and the renal tracts show normal drainage.