Letter to the Editor: Reverse Rotation of Kidney with Spina Bifida in an Adult

To the Editor, Rotational anomalies of kidney are a rare congenital entity. Isolated malrotation of kidney is even more rare. The adult kidney, as it assumes its normal position, orients itself such that calyces point laterally and pelvis faces medially. When this alignment is not exact, it is known as malrotation. Most often, malrotation is found in conjunction with another renal anomaly such as ectopia with or without fusion or with horseshoe kidney. We present here a 36-year-old male with bilateral flank pain and dysuria for 3 days. He had a history of fever on and off since the last 7 months. An ultrasound showed a calculus of 2 × 1 cm in the lower calyx of left kidney and bilateral mild hydronephrotic changes. X-ray KUB showed a radio opaque shadow of size 2 × 1 cm in the left renal area (Figure 1) and spina bifida occulta of L5 vertebra (marked by arrow in both the figures).