Horseshoe Kidney : Macroscopic

Macroscopic Appearance: In the vast majority of cases (95%), the kidneys are connected at the lower pole by a solid parenchymatous or fibrous isthmus, creating a horseshoe-shaped organ. In the remainder, there is an isthmus connecting the upper poles. The two kidneys may or may not be symmetrical. Each kidney has its own collecting system and an orthotopically inserted ureter. The renal pelves and ureters are anteriorly placed and pass ventral to the connecting piece. Besides having an abnormal shape, horseshoe kidneys often have ectopic location and are placed lower than normal. They may be located at the level of the sacral promontory or in the true pelvis behind the urinary bladder.