An Image of Hutch Diverticulum with Ureteric Insertion

Abstract

A 38-year-old male patient presented with complaints of occasional right loin pain, dysuria, and suprapubic tenderness for three weeks. The patient had no history of haematuria. Upon examination, the patient was afebrile, and vitals were stable. Blood tests revealed mild neutrophilic leukocytosis, and urine tests revealed a few pus cells. Further radiological investigations were conducted. An initial ultrasound performed outside, one week earlier, showed a small-sized right kidney measuring 8 cm with cortical scars, raised cortical echoes, and ill-defined corticomedullary differentiation. A small outpouching was noted in the posterior wall of the urinary bladder, suggestive of a diverticulum. The patient underwent a Micturating Cystourethrogram (MCU) to rule out vesico-ureteric reflux. The MCU showed reflux of contrast from the bladder into the right ureter and pelvi-calyceal system without dilatation, suggestive of grade-II vesico-ureteric reflux on the right-side. However, the diverticulum could not be delineated on the MCU since it was small.

Keywords

• cortical scars
• haematuria
• micturating cystourethrogram
• vesicoureteric reflux