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Case profile: Pseudodiverticulum of renal pelvis
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URORADIOLOGY
CASE PROFILE: PSEUDODIVERTICULUM
OF RENAL PELVIS
Intravenous urography (IVP) performed on a thirty-nine-year-old man with left flank pain revealed two small opaque calculi in the left upper collecting system, and what appeared to be a large diverticulum arising from the left renal pelvis (Fig. 1). At surgery, a calculus was found in the upper ureter just distal to the ureteropelvic junction. Further dissection revealed a large urine-filled cavity located posterior and
FIGURE 2.
IVP two weeks after surgery.
medial to the renal pelvis, and communicating with it via a hole within which protruded the second calculus. Biopsy of the walls of the cavity was done which showed only inflammatory tissue. A follow-up IVP several weeks postoperatively was normal (Fig. 2). Comment This pseudodiverticulum formed following erosion of a calculus through the full thickness of the renal pelvis. Urinary extravasation associated with an obstructing distal ureteral calculus, which occurs via the calyceal fornices, is a well-recognized entity, producing an irregular pattern of contrast material around the renal pelvis and upper ureter. The interesting radiographic feature of this case is the distinct outline of the extravasation, making it appear to be a mucosal-lined structure which was part of the collecting system. FIGURE 1.
re(B) of
Ralph DeVito, M.D. Martin Schiff, Jr., M.D. (Reprints) Yale University School of Medicine 789 Howard Avenue New Haven, Connecticut 06504
XXIV, NUMBER 1
89
(A) Scout film of upper abdomen veals two opacities in region of left renal pelvis. IVE thirty minutes, showing pseudodiverticulum left renal pelvis.
UROLOGY
i
JULY 1984 /
VOLUME
URORADIOLOGY
CASE PROFILE: PSEUDODIVERTICULUM
OF RENAL PELVIS
Intravenous urography (IVP) performed on a thirty-nine-year-old man with left flank pain revealed two small opaque calculi in the left upper collecting system, and what appeared to be a large diverticulum arising from the left renal pelvis (Fig. 1). At surgery, a calculus was found in the upper ureter just distal to the ureteropelvic junction. Further dissection revealed a large urine-filled cavity located posterior and
FIGURE 2.
IVP two weeks after surgery.
medial to the renal pelvis, and communicating with it via a hole within which protruded the second calculus. Biopsy of the walls of the cavity was done which showed only inflammatory tissue. A follow-up IVP several weeks postoperatively was normal (Fig. 2). Comment This pseudodiverticulum formed following erosion of a calculus through the full thickness of the renal pelvis. Urinary extravasation associated with an obstructing distal ureteral calculus, which occurs via the calyceal fornices, is a well-recognized entity, producing an irregular pattern of contrast material around the renal pelvis and upper ureter. The interesting radiographic feature of this case is the distinct outline of the extravasation, making it appear to be a mucosal-lined structure which was part of the collecting system. FIGURE 1.
re(B) of
Ralph DeVito, M.D. Martin Schiff, Jr., M.D. (Reprints) Yale University School of Medicine 789 Howard Avenue New Haven, Connecticut 06504
XXIV, NUMBER 1
89
(A) Scout film of upper abdomen veals two opacities in region of left renal pelvis. IVE thirty minutes, showing pseudodiverticulum left renal pelvis.
UROLOGY
i
JULY 1984 /
VOLUME