Related Experiment Videos
[7 cases of calyceal diverticula in children]
Insights
This study reviewed seven pediatric calyceal diverticula cases. Surgical intervention, often deroofing, is effective for complicated cases, while small diverticula may not require treatment.
Area of Science:
- Pediatric Urology
- Nephrology
- Congenital Abnormalities
Context:
- Calyceal diverticula are rare renal malformations.
- Diagnosis in children aged 2-16 years.
- Potential congenital origin or linked to vesico-tubular reflux.
Purpose:
- To analyze clinical presentation, management, and outcomes of pediatric calyceal diverticula.
- Evaluate treatment strategies for symptomatic and asymptomatic cases.
Summary:
- Seven pediatric cases of calyceal diverticula (CD) were analyzed.
- Symptoms included hematuria, urinary infection, abdominal pain, and enuresis.
- Five diverticula were upper pole; one contained an oxalate calculus.
- Three asymptomatic diverticula needed no treatment.
- Four complicated diverticula (calculus, hematuria, infections) underwent surgery (partial nephrectomy or deroofing).
- Deroofing with ligation is the preferred surgical approach for complicated CD.
Impact:
- Highlights the potential for late complications in small, asymptomatic calyceal diverticula.
- Deroofing operation is the elective procedure for complex cases.
- Surgical outcomes were generally good, with one case requiring secondary intervention.
Abstract:
Seven cases of calyceal diverticula were seen from 1967 to 1981 in children aged 2 to 16 years at the moment of diagnosis. Symptoms were: gross hematuria (2 cases), urinary infection (2 cases), recurrent abdominal pain (2 cases) or enuresia. All children had a single diverticulum. Five of the 7 diverticula were located at upper renal pole. One of the children presenting with hematuria and renal colic had an oxalic calculous within diverticulum. Three small diverticula did not require treatment and remained uncomplicated with a follow-up of 14,18 and 60 months. Four complicated diverticula (1 from oxalolithiasis, 1 from hematuria and 2 from urinary infection) required surgical removal, by partial nephrectomy (1 case) or deroofing operation with intradiverticular ligation of the communication channel (3 cases). Results were good in 3 children. Removal of adjacent parenchyma with a residual cavity was necessary 5 years later in the fourth child. The majority of children calyceal diverticula seem to be from congenital origin, but some authors suggest that the y could result from vesico-tubular reflux. The possibility of late complications from small and asymptomatic diverticula has been emphasized by many authors. The deroofing operation is certainly the elective procedure when a large or complicated diverticulum requires surgical treatment.