A successful case of a laparoscopic extraction with closure of the diverticulum for an anteriorly placed calculus in an infundibular diverticulum

摘要

The presence of symptomatic calculi in a calyceal diverticulum presents technical challenges due to the difficulty in safely accessing these stones. We present a successful case of a laparoscopic extraction with closure of the diverticulum for an anteriorly placed stone in an infundibular diverticulum in a 49-year-old woman who failed extracorporeal Shockwave lithotripsy (ESWL), flexible ureterorenoscopy (FURS) and percutaneous nephrolithotomy (PCNL). A 49-year-old woman was referred with a history of recurrent urinary tract infections. Investigations showed two areas of calcification in the upper pole, which were unaltered by ESWL (see Figure 1). At FURS we were unable to access the upper pole and she proceeded to mini-PCNL which cleared all visible stone from the collecting system. At the end of the procedure a small rim of stone remained in what appeared to be an inaccessible, anteriorly placed infundibular diverticulum from the upper pole adjacent to the renal vessels (see Figure 2).