TY - JOUR T1 - CT-guided percutaneous nephrostomy in an obstructed pelvic pancake kidney: a report of a novel transiliopsoas approach JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-232665 VL - 12 IS - 12 SP - e232665 AU - Akhil Baby AU - Praveen Kesav AU - Pawan Kumar AU - Kumble Seetharama Madhusudhan Y1 - 2019/12/01 UR - http://casereports.bmj.com/content/12/12/e232665.abstract N2 - 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. ER -