Calyceal diverticula (CD): diagnosis and management options in the era of non-contrast CT KUB
BAUS ePoster online library. Abushamma F.
Jun 26, 2018; 211311
Disclosure(s): None
Mr. Faris Abushamma
Mr. Faris Abushamma
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Abstract
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Introduction: Calyceal diverticula (CD) are traditionally diagnosed by contrast studies such as IVU, CT urogram or retrograde. IVU has largely been abandoned as an imaging modality with the advent of non-contrast CT (NCCT).

Materials and Methods: We have retrospectively studied 48 patients diagnosed with CD since 2000 analysing the timing and modality of CD diagnosis, type and number of procedures, and success rate. Treatment failure was defined as the requirement for further intervention.

Results: All patients underwent a non-contrast CT at the time of presentation. Only 31% had a contrast study (IVU or CT urogram) before intervention. 52% required 1- 2 procedures before a diagnosis was established. In 27% the diagnosis was profoundly delayed, after an average of 5 interventions. The success rate for the first treatment is 69% if CD was diagnosed pre-operatively, compared to 0% if diagnosed at the time of the procedure, typically retrograde pyelography at the time of flexible ureterorenoscopy (FURS) for failed ESWL. For instance, FURS success as a first procedure with preoperative diagnosis is 50% while 0% if CD was diagnosed intraoperatively.

Conclusions: We believe that the delay in diagnosis of CD contributes significantly to the success rate and number of treatments. In the era of NCCT to diagnose kidney stones, contrast studies are essential if CD is a potential diagnosis, i.e. if NCCT raises suspicions or a stone is refractory to ESWL.
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