For six years, a woman suffered bouts of pain where it seems a ball was rolling inside her. Her condition was diagnosed as a "floating kidney."
The 28-year-old woman endured a recurring pain that has a very similar pattern. Once it attacks, she would feel pain in her right abdominal pain. The pain would subside when she reclines only to get worse when she stands. Also, when she changes her position, she feels as if a ball was rolling inside her, back and forth.
The patient experienced no other symptoms. Interestingly, the episodes decreased while she was pregnant, particularly while she was in her later trimesters.
The Case Of A Floating Kidney
The woman from Michigan had sought the help of several physicians in different hospitals over the years but to no avail. That is until she was examined by Dr. Akshay Sood, a urologist at Henry Ford Hospital.
In the case published in the journal BMJ Case Reports, Sood states that the woman's right kidney had been wandering almost 6 centimeters down to her pelvis when she shifts from lying down to standing up. After performing a process he called intravenous pyelography, she was diagnosed with a "floating kidney" or what medically called as nephroptosis.
Nephroptosis is a condition in which the kidney falls more than two vertebral bodies or more than 5 centimeters when a person changes from lying to an upright position.
Interestingly, the condition is more common in thin women but the majority who has the condition shows no symptoms. An absence of fat, specifically the fat surrounding the kidney is suspected to be the main culprit for the condition.
Sood explains that body fat normally surrounds and supports the kidney. These tissues keep the kidney in place inside the human body. In the case of thin women, there is not enough fat to support the kidney, causing it to fall into the pelvis when they stand up, particularly because of gravity.
When the kidney falls into the pelvis, it hooked the blood vessels that are attached to it. The movement also causes a bend in the ureter which in return causes a problem in producing urine. The urine will flow back into the kidney without a means of exit. This causes the kidney to swell up until eventually causes pain to the person.
'Floating Kidney' Diagnosis
Sood explains further that floating kidney is a hard condition to diagnose because it can only be detected when the patient is standing. CT scans, which are the common tests for internal problems, are conducted while the person is lying down. Even if the patient is experiencing pain during scans, but that he or she was lying down, all scans will return negative for any anomaly that could reveal a "floating kidney."
Sood adds that urologists at present may have limited knowledge about Nephroptosis because of previous censorship about the condition. He said there were significant cases of misdiagnosis, overdiagnosis, and overtreatment of a floating kidney about 20 to 30 years ago. This resulted in some institutions teaching less about the condition during medical training.
'Floating Kidney' Treatment
For the 28-year-old patient, she was taken to the operating room for a robot-assisted laparoscopic nephropexy. She was sent home one day after the kidney surgery.
During her follow-up check-up, she said the pain is gone and was grateful that she is finally free from it after six years.