- Etiology: ascending kidneys hooked on inferior mesenteric vein leading to fusion of lower poles and anteriorly placed renal pelvis + ureters
- Imaging: challenge is how to determine lengths of component left and right kidneys
- Complications: prone to stasis / stone / infection / scarring, ureteropelvic junction obstruction, increased risk of bleeding secondary to trauma due to isthmus anterior to spine, increased risk of cancer
