ESPN 50th Annual Meeting

ESPN 2017


 
Diagnostic dilemma: Renal simple cyst and calyceal diverticulum
DEMET ALAYGUT 1 HILAL ŞAHIN 2 SEÇIL ARSLANSOYU ÇAMLAR 1 ELIF PERIHAN ÖNCEL 1 CANER ALPARSLAN 1 EREN SOYALTIN 1 FATMA MUTLUBAŞ 1 ÖNDER YAVAŞCAN 1 BELDE KASAP DEMIR 3

1- TEPECIK TRAINING AND RESEARCH HOSPITAL PEDIATRIC NEPHROLOGY CLINIC, IZMIR, TURKEY
2- TEPECIK TRAINING AND RESEARCH HOSPITAL DEPARTMENT OF RADIOLOGY, IZMIR, TURKEY
3- KATIP CELEBI UNIVERSITY FACULTY OF MEDICINE, DEPARTMENT OF PEDIATRIC NEPHROLOGY, İZMIR,TURKEY
 
Introduction:

Renal calyceal diverticulum is a cystic formation related to the pelvicalyceal system which is rarely diagnosed in childhood age group and can be confused with other cystic diseases of the kidney. Due to the relationship with the pelvicalyceal system, it can cause clinical symptoms such as infection,  stone formation and hematuria.

Material and methods:

The children with a diagnosis simple renal cysts and with detailed ultrasonographic findings and advanced imaging results  of the renal cyst were evaluated retrospectively according the their age, sex, presenting symptoms, simple renal cyst features (size, location) and advanced imaging results. 

Results:

A total of 22 cases (11 girls) were evaluated. Mean ages were  10.5 ± 3.9 (5-18) years. Simple renal cyst was detected in 13 left, 7 right kidney and  two both of the kidneys.  The mean size of the cysts were  21 ± 11.5 (10-58) mm. The location of the cysts were 11 corticomedullary, 4 cortical, 6  medullary, and 1 parapelvic. All of the cases had been evaluated with MR urography as advanced imaging. MR urographic results showed that  totally 7  calyceal diverticulum (31%)  in all of the patients .  The other 15 simple renal cysts diagnosis were confirmed as renal cyst. The presenting symptoms of cases with calyceal  diverticulum were ;  3 with  abdominal pain, 2 with  microscopic hematuria, 2 with  urinary tract infection. Other cases were asymptomatic. Ultrasonographic cyst sizes of patients with diverticulum detected by MR urography were 20.8 ± 6.1 mm (10-30) in average and there was no significant difference in terms of cyst size. None of the cases of cayceal diverticulum require surgical intervention. 

Conclusions:

 It should be kept in mind that some of the patients with simple renal cysts may be calyceal diveritculum.  MR urography can be used safely with advanced imaging techniques in differential diagnosis.