Nephroptosis, also known as floating kidney or renal ptosis, is characterized by the descent of the kidney more than 5 cm or two vertebral bodies during the transition from supine to upright posture. While often asymptomatic, symptomatic nephroptosis can lead to abdominal pain and other complications.

We present a case of nephroptosis in a 53-year-old female with progressive abdominal fullness with poor appetite over 6 months. Dynamic imaging, specifically intravenous pyelography in both supine and upright positions, was utilized to assess renal mobility. A comprehensive review of existing literature on nephroptosis case reports was conducted to contextualize our findings in electronic databases.

The patient exhibited a 6 cm craniocaudal migration of the right kidney between supine and upright positions, confirming the diagnosis of nephroptosis. Physical examination revealed a slender build with a palpable mass in the right lower quadrant during deep inspiration. The patient undergone a laparoscopic nephropexy, and postoperative follow-up at 4 weeks after surgery showed significant symptom relief. Similar situation was noted in other cases with non-specific symptoms including discomfort, distension upon position change.

Nephroptosis should be considered in young, thin women presenting with unexplained abdominal discomfort, especially when symptoms are relieved by lying down. Dynamic imaging is essential for accurate diagnosis. Laparoscopic nephropexy offers an effective treatment option for symptomatic cases. It is crucial to consider nephroptosis as a differential diagnosis.