ESWL of Caliceal Diverticula Calculi

Jo, Eui Je; Kang, Sang Jae; Shin, Se Jong; Choi, Sung Hyup

Abstract

Caliceal diverticula are eventrations of the upper collecting system lying within the renal parenchyma and communicating with renal pelvis or a calyx through a narrow channel. The incidence on a routine IVP is approximately 0.21 to 0.45 percent and stone formation in a caliceal diverticulum has arised from 9.5 to 50 percent. Traditionally, treatment has included nephrotomy with extraction of the calculi and percutaneous nephrolithotripsy, but more recently ESWL has been challenged due to less invasive and safer procedure. We report the results of 11 patients with calculi in caliceal diverticula treated with EDAP LT-01 lithotriptor. All patients were followed during 2-11 months (average in 6.6) The results were obtained as follows ; 1. The symptoms were included chronic vague flank pain in seven, acute renal colic in two, epigastric discomfort in one and incidentally diagnosed in one. 2. The location of diverticula were upper third in seven, mid third in three and lower third of kidney in one. The stone size showed under 10mm in seven, 11-20mm in three and over 21mm in one. 3. The average numbers of treatment were 2.2 sessions and average storage was 102. 4. The complete success rate in 63.6 % (stone free rate in 45.5 %) and partial success rate in 27.2% were showed. 5. The complete relief of symptom was in eight (72.7% ), partial in one (9.1%) and persistent symptom in two (18.2 9t ). 6. Complication was showed only gross hematuria for 1 day in 63.6 %, but all patients recovered with conservative treatment. Therefore, the possibility of producing a satisfactory result (relief of symptom in 81.1%) and the low morbidity of ESWL suggest that this treatment may be appropriate for calculi in caliceal diverticuli.