British Journal of Uro1og.v (1975), 41,310 @
Short Case Report
An Unusual Complication of Calyceal Diverticulum C a w Report A girl was investigated for day and night urinary incontinence at the age of 4 years. An intravenous pyelogram showed a calyceal diverticulum in the right kidney (Fig. l), and a micturating cystogram showed vesico-ureteric reflux on the same side. Further intravenous pyelograms at the ages of 7 and 8 years showed no change in the diverticulum but the reflux was never again demonstrated. At the age of 12 she became ill with fever and a palpable mass in the right loin. This was due to a large cyst in the upper pole of the right kidney, apparently at the site of the previously noted calyceal diverticulum (Fig. 2). It is surmised that the diverticulum became sealed off and converted into a cyst. Partial nephrectomy was performed.
Comment Calyceal diverticulum is a rare but well recognised entity (Lister and Singh, 1973). It is sometimes dismissed as an abnormality of no significance but of 54 cases reviewed by Keller, Bettex and Kuffer, 24 came to operation, most of these because of symptoms related to urinary infection or stone formation in the diverticulum. The complication described here, mainly conversion of diverticulum to sealed-off cyst, would seem to be unusual as no similar case has been found in the literature. It is presented as further evidence that calyceal diverticulum is not a negligible condition. Acknowledgements I would like to thank Mr D. M. Forrest, F.R.C.S., and Dr F. Starer for permission to publish the case. JOHN L. NICHOLAS The Westminster Children’s Hospital, London S. W.l, and Queen Mary’s Hospital for Sick Children, Carshalton, Surrey.
References KELLER,V., BETTEX,M. and KUFFER,F. (1974). Ten cases with pyelogenous cysts. Zeitschrut fur Kinderchirurgie, 14, 303-31 1. LISTER,J. and SINGH,H. (1973). Pelvicalyceal cysts in children. Journal of Paediatric Surgery, 8,901-
Fig. 2. At 12 years, diverticulum replaced by
a large closed-off cyst.
905.
370
Short Case Report
An Unusual Complication of Calyceal Diverticulum C a w Report A girl was investigated for day and night urinary incontinence at the age of 4 years. An intravenous pyelogram showed a calyceal diverticulum in the right kidney (Fig. l), and a micturating cystogram showed vesico-ureteric reflux on the same side. Further intravenous pyelograms at the ages of 7 and 8 years showed no change in the diverticulum but the reflux was never again demonstrated. At the age of 12 she became ill with fever and a palpable mass in the right loin. This was due to a large cyst in the upper pole of the right kidney, apparently at the site of the previously noted calyceal diverticulum (Fig. 2). It is surmised that the diverticulum became sealed off and converted into a cyst. Partial nephrectomy was performed.
Comment Calyceal diverticulum is a rare but well recognised entity (Lister and Singh, 1973). It is sometimes dismissed as an abnormality of no significance but of 54 cases reviewed by Keller, Bettex and Kuffer, 24 came to operation, most of these because of symptoms related to urinary infection or stone formation in the diverticulum. The complication described here, mainly conversion of diverticulum to sealed-off cyst, would seem to be unusual as no similar case has been found in the literature. It is presented as further evidence that calyceal diverticulum is not a negligible condition. Acknowledgements I would like to thank Mr D. M. Forrest, F.R.C.S., and Dr F. Starer for permission to publish the case. JOHN L. NICHOLAS The Westminster Children’s Hospital, London S. W.l, and Queen Mary’s Hospital for Sick Children, Carshalton, Surrey.
References KELLER,V., BETTEX,M. and KUFFER,F. (1974). Ten cases with pyelogenous cysts. Zeitschrut fur Kinderchirurgie, 14, 303-31 1. LISTER,J. and SINGH,H. (1973). Pelvicalyceal cysts in children. Journal of Paediatric Surgery, 8,901-
Fig. 2. At 12 years, diverticulum replaced by
a large closed-off cyst.
905.
370
