Abstract
Renal calyceal diverticulum is a non-secretary urothelium cavity in the renal parenchyma communicating with calyx allowing for passive filling with urine. Calyceal diverticula are found incidentally in 0.21% to 0.6% of intravenous urograms in adults. Stone formation occurs in about 10-50% cases of renal calyceal diverticula. Symptomatic case needs treatment. Digital flexible ureteroscopy with Holmium laser infundibulotomy and laser lithotripsy is beneficial in terms of shorter hospital stay, better stone clearance and minimal complications in comparison with those of other modalities. Cases of stenotic infundibulum have been addressed adequately but infundibular atresia has been rarely reported. Therefore, we present a symptomatic case of calyceal diverticular stone with infundibular atresia managed by disposable flexible ureteroscopy with holimium laser infundibulotomy and laser lithotripsy.
Highlights
Fulgura on of the diver cular neck with holmium laser during flexible ureterorenoscopy (f-URS) is found beneficial with respect to a shorter hospital stay, symptom free outcome and minimal complica ons.[3]
We report a case of renal calyceal diver cular stone managed by f-URS with laser infundibulotomy
Renal calyceal diver culum is a non-secretary urothelium cavity in the renal parenchyma communica ng with calyx allowing for passive filling with urine
Summary
It is a difficult task to manage an abnormal anatomically placed kidney stone.[1]. Minimal invasive methods like extra corporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), laparoscopy and flexible ureterorenoscopy (f-URS) are the current modali es accepted for the management of renal calyceal diver cular stone (CDS).[2]. We report a case of renal calyceal diver cular stone managed by f-URS with laser infundibulotomy. CECT scan of whole abdomen showed calyceal diver cular stone measuring 11.8x9.2 mm (1218 HU) near upper pole of right kidney. There was no contrast excre on noted from the diver culum into the calyceal system (Figure 1) She underwent disposable f-URS with laser infundibulotomy (Holmium Laser, 200μm, 1.0J, 10 Hz at long pulse) and laser lithotripsy (Holmium Laser, 200μm, 0.5-1.0J, 0.5-10 Hz at both long and pulse). Figure 3: 3a) Blue patch mucosal area near the upper pole calyx following Blue Spritz technique, 3b) Laser infundibulotomy, 3c) Stone in diver culum stone was iden fied and laser lithotripsy done. Confirma on of complete stone clearance was done 3 months following the procedure by sonography kidney, ureter and bladder (USG KUB)
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