The anomalies of kidney form a sizeable part of all the congenital malformations. Generally defects in ascent ofkidney are associated with variations in branching pattern of the abdominal aorta. Here we report a case of unilateralunascended right kidney with malrotation in a 60 yrs old male cadaver with associated vascular variations. The right kidney was larger in size, laterally rotated and placed at a lower lumbar level showing varied branching pattern ofrenal vasculature. The left kidney was normally placed with hilum directed medially and a normal renal vasculature.

Failure of the kidney to ascend into the renal fossa in utero results in Ectopic kidney. Such kidney is often found in the pelvis however it may be placed higher up in lower lumbar region. Pelvic kidneys often become hydronephrotic due to obstruction of the anteriorly placed ureter and an anomalous arterial supply. No such gross changes were seen in our case.

The embryological basis of rotational anomalies is still unknown. Rotational anomaly though rare, has important implications from surgical point of view, as it may be mistaken for some more serious condition on Intravenous Pyelography (IVP). It may erroneously be attributed to displacement by para vertebral mass / tumour. It also assumes a great importance in the context of present day surgical procedures like percutaneous nephrectomy where modified technique is required for upper pole access in malrotated kidneys. Though malrotated kidney without any history of calculi or hydronephrosis is hardly rejected for donation a detailed CT Scan is a must for preoperative diagnostic evaluation of donors to minimise iatrogenic damages.

Keywords: Ectopic kidney, Malrotation, hilum, hydronephrotic, pyelography, nephrectomy