Percutaneous infundibuloplasty: management of calyceal diverticula and infundibular stenosis.
Calculi in calyceal diverticula or behind stenotic renal infundibula are generally managed with percutaneous extraction. Percutaneous infundibuloplasty, a relatively noninvasive technique, is advocated to drain and eradicate the potentially infected space and can be performed at the same time as stone extraction. A communication between the diverticulum and renal pelvis is created by passing a transjugular cholangiographic needle under fluoroscopic or visual guidance, dilating the tract with a balloon catheter, and placing a stent until uroepithelial coverage has occurred. Stenotic infundibula are dilated in a like fashion. During 7 years, six (60%) of 10 patients with such "neoinfundibula" draining calyceal diverticula remained patent for at least 2 years. In two more patients (20%), both the calyceal diverticular cavity and neoinfundibulum were obliterated; in only one patient (10%) was there a residual cavity after the neoinfundibulum became obstructed. One patient was lost to follow-up. Long-term correction of infundibular stenoses was achieved with this technique in four (67%) of six patients, and there were no renal or perirenal abscesses.
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Department of Radiology, Louisiana State University Medical Center, New Orleans 70112-2822.
D000328:Adult; D003251:Constriction, Pathologic; D004240:Diverticulum / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D007670:Kidney Calices / Q000000981:diagnostic imaging / Q000473:pathology*; D007674:Kidney Diseases / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D015641:Radiography, Interventional