Calyceal diverticulum
Updates to Article Attributes
Calyceal diverticulumdiverticula,alsoknown as pyelocalyceal diverticulumdiverticula is aare congenital abnormality that results in urine filled out pouching, lined with transitional epitheliumoutpouchings from the renal calyx or pelvis into the renal cortex. These diverticula are lined with transitional/urothelial epithelium.
Epidemiology
Relatively uncommon, seen in 0.21% to 0.60% of intravenous urogramurograms (IVU).
Risk factorsAssociations include:
- gender: females are more commonly affect than men by a ratio of 2:1
Associations include:
- high incidence of stone formation due to urine stagnation
Clinical presentation
The majority of the time this is an asymptomatic congenital pathology is asymptomaticvariant and discovered when patients present for other complications such as hematuria, calculi, or repeated infections all being related to urine stasis.
Pathology
The most common theory is congenitalfor the origin of diverticulum results fromcalyceal diverticula is a failure of regression of the third and fourth-generation ureteric buds, as a result of obstructing stones or infection.
There are two categories of calyceal diverticulum thediverticula. The first and more common type communicates with a minor calyx and the. The second, communicates communicates with a major calyx or the renal pelvis.
Radiographic features
Plain radiograph
Plain abdominal radiographers will oftenrarely show a half moon ofcrescent-shaped meniscus shaped calcification of radio-opaque milk of calcium within a diverticulum.
Ultrasound
A calyceal diverticulum complicated by calculi or layered dependent milk of calcium appears echogenic on ultrasound
CT
Nephrographic phase contrast-enhanced CT will have an appearance similar to that of a simple cyst. The diagnosis is made with certainty in the excretory phase of imaging, the cystic structure fills with contrast material due to communicationcommunication with pelvi-calycesthe collecting systeem, and layering of contrast material is seen within. This helps differentiate it from a renal cyst, which does not connect with the collecting system.
A calyceal diverticulum complicated by calculi or layered dependent milk of calcium will be a high-attenuating material on an unenhanced CT with fluid milk level.
Differential diagnosis
General imaging differential considerations include:
-<p><strong>Calyceal diverticulum,</strong><strong> </strong>also<strong> </strong>known as<strong> p</strong><strong>yelocalyceal diverticulum</strong> is a congenital abnormality that results in urine filled out pouching, lined with transitional epithelium from the renal calyx or pelvis into the renal cortex. </p><h4>Epidemiology</h4><p>Relatively uncommon, seen in 0.21% to 0.60% of intravenous urogram (IVU).</p><p>Risk factors include:</p><ul><li>gender: females are more commonly affect than men by a ratio of 2:1 </li></ul><p>Associations include:</p><ul><li>high incidence of stone formation due to urine stagnation</li></ul><h4>Clinical presentation</h4><p>The majority of the time this congenital pathology is asymptomatic and discovered when patients present for other complications such as hematuria, calculi, or repeated infections all being related to urine stasis.</p><h4>Pathology</h4><p>The most common theory is congenital origin of diverticulum results from failure of regression of the third and fourth-generation ureteric buds, as a result of obstructing stones or infection.</p><p>There are two categories of calyceal diverticulum the first and more common type communicates with a minor calyx and the second, communicates with a major calyx or the renal pelvis<strong>.</strong></p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Plain abdominal radiographers will often show a half moon of meniscus shaped calcification of radio-opaque milk of calcium.</p><h5>Ultrasound</h5><p>A calyceal diverticulum complicated by calculi or layered dependent milk of calcium appears echogenic on ultrasound</p><h5>CT</h5><p>Nephrographic phase contrast-enhanced CT will have an appearance similar to that of a simple cyst. The diagnosis is made with certainty in the excretory phase of imaging, the cystic structure fills with contrast material due to communication with pelvi-calyces, and layering of contrast material is seen within.</p><p>A calyceal diverticulum complicated by calculi or layered dependent milk of calcium will be a high-attenuating material on unenhanced CT with fluid milk level.</p><h4>Differential diagnosis</h4><p>General imaging differential considerations include:</p><ul>- +<p><strong>Calyceal diverticula,</strong><strong> </strong>also<strong> </strong>known as<strong> p</strong><strong>yelocalyceal diverticula</strong> are congenital outpouchings from the renal calyx or pelvis into the renal cortex. These diverticula are lined with transitional/urothelial epithelium.</p><h4>Epidemiology</h4><p>Relatively uncommon, seen in 0.21% to 0.60% of intravenous urograms (IVU).</p><p>Associations include:</p><ul>
- +<li>gender: females are more commonly affect than men by a ratio of 2:1</li>
- +<li>high incidence of stone formation due to urine stagnation</li>
- +</ul><h4>Clinical presentation</h4><p>The majority of the time this is an asymptomatic congenital variant and discovered when patients present for other complications such as hematuria, calculi, or repeated infections.</p><h4>Pathology</h4><p>The most common theory for the origin of calyceal diverticula is a failure of regression of the third and fourth-generation ureteric buds, as a result of obstructing stones or infection.</p><p>There are two categories of calyceal diverticula. The first and more common type communicates with a minor calyx. The second communicates with a major calyx or the renal pelvis<strong>.</strong></p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Plain abdominal radiographers will rarely show a crescent-shaped meniscus calcification of radio-opaque milk of calcium within a diverticulum.</p><h5>Ultrasound</h5><p>A calyceal diverticulum complicated by calculi or layered dependent milk of calcium appears echogenic on ultrasound</p><h5>CT</h5><p>Nephrographic phase contrast-enhanced CT will have an appearance similar to that of a simple cyst. The diagnosis is made with certainty in the excretory phase of imaging, the cystic structure fills with contrast material due to communication with the collecting systeem, and layering of contrast material is seen within. This helps differentiate it from a renal cyst, which does not connect with the collecting system.</p><p>A calyceal diverticulum complicated by calculi or layered dependent milk of calcium will be a high-attenuating material on an unenhanced CT.</p><h4>Differential diagnosis</h4><p>General imaging differential considerations include:</p><ul>
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