Urolithiasis associated with bilateral pelvic diverticula: a case report.

Area of Science:

• Nephrology
• Urology
• Radiology

Background:

• Renal stones (urolithiasis) are common, but their association with renal pelvis diverticula is rare.
• Initial diagnosis often relies on ultrasonography and KUB radiography.

Observation:

• A patient presented with a large right renal pelvis calculus initially diagnosed via ultrasonography and KUB.
• Extracorporeal shock wave lithotripsy failed to yield stone fragments, prompting further investigation.
• Advanced imaging, including intravenous urography and contrast-enhanced CT, revealed bilateral renal pelvis diverticula with retained stone fragments in the right diverticulum.

Findings:

• Bilateral renal pelvis diverticula can be associated with renal calculi.
• Failure to fragment stones with extracorporeal shock wave lithotripsy may indicate an underlying anatomical abnormality.
• Contrast-enhanced imaging is crucial for diagnosing renal pelvis diverticula and associated stones.

Implications:

• Intravenous urography and contrast-enhanced CT are essential for accurate diagnosis of renal cystic lesions and complex urolithiasis.
• This case underscores the importance of comprehensive imaging when initial stone treatment is unsuccessful.
• Recognizing this association can improve diagnostic accuracy and treatment planning for patients with challenging renal stone cases.