A calyceal diverticulum is a rare urological condition that affects the kidneys. It is a small sac-like structure that forms in one of the calyces of the kidney, which is a structure that collects urine before it flows into the renal pelvis and ureter. Calyceal diverticula are usually benign and do not cause any symptoms, but they can sometimes cause urinary tract infections or kidney stones.
The exact cause of calyceal diverticula is unknown, but they are thought to be congenital, meaning they are present from birth. They can also be acquired, meaning they develop later in life as a result of kidney damage or infection. Calyceal diverticula are more common in women than men and typically occur in people between the ages of 30 and 50.
Calyceal Diverticulum Symptoms
Many people with calyceal diverticulum do not experience any symptoms and the condition may be discovered incidentally during a routine medical exam or imaging study. However, in some cases, calyceal diverticulum can cause symptoms such as:
Recurrent urinary tract infections
The diverticulum can become a breeding ground for bacteria, which can lead to recurrent infections.
Flank pain
In some cases, calyceal diverticulum may cause pain in the back or side of the affected kidney.
Hematuria
Blood in the urine may occur due to irritation of the lining of the diverticulum.
Kidney stones
Stones may form within the diverticulum or may develop in the urinary tract as a result of the diverticulum's presence.
Hydronephrosis
This condition occurs when urine builds up in the kidney and causes it to swell. It can occur if the diverticulum obstructs the flow of urine from the kidney.
Calyceal Diverticulum Causes
The exact cause of calyceal diverticulum is not fully understood, but there are several theories that attempt to explain its development. Some possible causes of calyceal diverticulum are:
Congenital
Calyceal diverticulum may be present from birth and develop as a result of abnormal embryonic development.
Acquired
The condition may also develop later in life due to damage or inflammation of the kidney or urinary tract.
Obstruction
Obstruction of the calyceal system may result in an increase in pressure, which can cause the formation of a diverticulum.
Infection
In some cases, calyceal diverticulum may be associated with chronic urinary tract infections or pyelonephritis.
Trauma
Injury to the kidney or urinary tract may cause the development of a diverticulum.
Genetics
There may be a genetic predisposition to the development of calyceal diverticulum.
Calyceal Diverticulum Ultrasound
On an ultrasound image, a calyceal diverticulum may appear as a small, fluid-filled sac that protrudes from the calyx of the kidney. However, other conditions such as cysts or tumors may appear similar on ultrasound, and further imaging tests may be necessary to confirm a diagnosis.
Ultrasound is a safe and painless procedure that does not use radiation, making it a good option for patients who cannot have other imaging tests such as CT or MRI due to radiation exposure or other factors. However, the accuracy of ultrasound for diagnosing calyceal diverticulum depends on the size and location of the diverticulum, and it may not be able to detect small or deep-seated diverticula.
Calyceal Diverticulum Treatment
The treatment for calyceal diverticulum depends on the severity of the condition and the presence of symptoms. In many cases, no treatment is necessary if the diverticulum is small and does not cause any symptoms. However, if the diverticulum causes recurrent infections or kidney stones, treatment may be required.
Antibiotics
If the patient has a urinary tract infection, antibiotics may be prescribed to treat the infection and prevent future infections.
Pain relief
Over-the-counter pain relievers such as acetaminophen or ibuprofen may be used to relieve mild pain or discomfort.
Surgical intervention
If the diverticulum is large, deep-seated, or causing significant symptoms, surgery may be necessary. The type of surgery will depend on the size and location of the diverticulum and the overall health of the patient. Surgical options may include open surgery or minimally invasive techniques such as laparoscopy or robotic-assisted surgery.
Observation
In some cases, observation may be recommended to monitor the diverticulum for any changes or progression. Regular imaging tests may be necessary to monitor the condition.