Also known as: Floating kidney
A 38-year-old Hasidic woman presents with hematuria, loss of bladder control, leg pain, altered mental status, and orthostatic hypotension. The team considers multiple diagnoses including porphyria, lupus, Wegener's, and Addison's disease. House eventually diagnoses nephroptosis (floating kidney) by having her stand up during examination, revealing that her kidney drops when upright, causing all symptoms. The condition would have been missed in surgery since patients lie down for scans and operations.
Also known as: Internal bleeding
The patient develops internal bleeding as a complication of her nephroptosis, causing abdominal swelling and hypovolemic shock. The bleeding source cannot be localized on imaging, requiring emergency surgical exploration. The patient delays surgery to observe Shabbat with her new husband.