PT  - JOURNAL ARTICLE
AU  - Baby, Akhil
AU  - Kesav, Praveen
AU  - Kumar, Pawan
AU  - Madhusudhan, Kumble Seetharama
TI  - CT-guided percutaneous nephrostomy in an obstructed pelvic pancake kidney: a report of a novel transiliopsoas approach
AID  - 10.1136/bcr-2019-232665
DP  - 2019 Dec 01
TA  - BMJ Case Reports
PG  - e232665
VI  - 12
IP  - 12
4099  - http://casereports.bmj.com/content/12/12/e232665.short
4100  - http://casereports.bmj.com/content/12/12/e232665.full
SO  - BMJ Case Reports2019 Dec 01; 12
AB  - 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.