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Case report
CT-guided percutaneous nephrostomy in an obstructed pelvic pancake kidney: a report of a novel transiliopsoas approach
  1. Akhil Baby,
  2. Praveen Kesav,
  3. Pawan Kumar and
  4. Kumble Seetharama Madhusudhan
  1. Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Kumble Seetharama Madhusudhan; drmadhuks{at}


Pancake kidney is a rare renal fusion anomaly with increased risk of complications, such as stone disease and infections, due to altered urodynamics. Image-guided (ultrasonography and fluoroscopy) percutaneous nephrostomy (PCN) is performed to decompress an obstructed pancake kidney. However, routine image guidance may be unable to provide a suitable access in complex clinical scenarios. The approach for PCN in a low-lying fused kidney is difficult due to a limited safe posterior retroperitoneal paraspinal route, and anterior transperitoneal approach poses risks of urine leak and peritonitis. We report a case of an obstructed pancake kidney managed by CT-guided PCN through a transiliopsoas approach.

  • urology
  • urinary tract infections
  • ultrasonography
  • interventional radiology

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  • Contributors AB: manuscript preparation and literature review. PKe: literature review. PKu: data collection and final editing. KSM: final editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.