Objective

Calyceal diverticulum (CD) is rarely diagnosed in children. It mimics other cystic lesions of the kidney and may be very difficult to identify. Displaying the communication of these fluid-filled cavities with the collecting system of the kidney via imaging methods is the key diagnostic method. The purpose of this study is to determine the presence of calyceal diverticulum in pediatric patients followed up due to simple renal cyst and/or parapelvic cyst.

Material, and method

Patients who were newly diagnosed or being followed up with the ultrasonographic diagnosis of simple cyst(s) or parapelvic cyst(s) in the Department of Pediatric Nephrology of Izmir University of Health Sciences Tepecik Training and Research Hospital between December 2015 and July 2018 were included in the study. Age, gender, admission symptoms, recurrent urinary tract infections, stone disease, trauma history, accompanying urinary system and systemic anomalies, localization, and size of the cyst(s) at admission and during follow-up, treatment type and developing complications were noted. Contrast MR urography was applied to all patients.

Results

A total of 43 patients [mean age:132 ± 54.9 (12–228) months] including 25 girls were enrolled in the study. The mean follow-up period was 36. 74 ± 19 (1–90) months. The cysts were located mostly in the right kidney and also in the upper pole of the kidney. The mean cyst size was 20.4 ± 11 (8–58) mm at admission, and comparably 20.3 ± 8.6 (10–45) mm at the end of the follow-up. In contrast MR urography, a total of 16 cases were observed at first glance to be associated with pelvicalyceal system. However, in the postcontrast images taken at the 5th minute it was determined that 9 of them were compatible with calyceal diverticulum.

Conclusion

Although it is thought that well-circumscribed solitary renal fluid collections may be thought to be a simple renal cyst at first glance, the differential diagnosis of calyceal diverticulum (CD) should be absolutely kept in mind. Contrast studies and late-phase postcontrast images are needed for the diagnosis of CD. Although the standard management of CDs in children is conservative, surgical intervention may be rarely required.

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中文翻译：

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小儿患者肾脏的肾小憩室-是否像您想像的那样罕见？

目的

小儿憩室（CD）很少被诊断。它模仿肾脏的其他囊性病变，可能很难识别。关键的诊断方法是通过成像方法显示这些充满液体的腔体与肾脏收集系统的连通性。这项研究的目的是确定由于单纯性肾囊肿和/或骨盆旁囊肿而接受随访的小儿患者是否存在肾小憩室。

材料和方法

纳入2015年12月至2018年7月间在伊兹密尔健康科学大学特佩西克训练与研究医院小儿肾内科新诊断或接受超声检查的简单囊肿或盆腔旁囊肿的患者在研究中。年龄，性别，入院症状，复发性尿路感染，结石病，外伤史，伴随的泌尿系统和全身异常，入院时和随访期间囊肿的位置和大小，治疗类型和发展中的并发症。对比MR尿路造影术适用于所有患者。

结果

该研究共纳入43名患者[平均年龄：132±54.9（12–228）个月]，其中包括25名女孩。平均随访期为36. 74±19（1–90）个月。囊肿主要位于右肾，也位于肾脏的上极。入院时平均囊肿大小为20.4±11（8–58）mm，随访结束时平均为20.3±8.6（10–45）mm。相比之下，MR尿路造影乍看之下总共有16例与骨盆腔系统有关。但是，在第5分钟拍摄的对比后图像中，确定其中有9个与肾盏憩室兼容。

结论

尽管人们认为乍看之下界限分明的孤立性肾液收集物可能是简单的肾囊肿，但绝对应牢记对肾盂憩室（CD）的鉴别诊断。诊断CD需要进行对比研究和后期对比图像。尽管儿童CD的标准管理较为保守，但可能很少需要手术干预。

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