Pediatric Congenital Megacalyces

  • Etiology:
    — Underdevelopment of renal medullary pyramids resulting in enlargement in size of calyces
    — There may also be an increased number of calyces
  • Imaging:
    — Enlarged calyces which have a flat appearance as they lack the normal imprint of the papillae
    — Renal pelvis is normal in size
    — There may be an increased number of calyces
  • DDX: Hydronephrosis
  • Complications: Predisposition to urine stasis and infection and stone formation
  • Treatment: None unless complicated by infection or stones
  • Clinical:

Radiology Cases of Congenital Megacalyces

IVP of congenital megacalyces
Excretory phase image from a vintage intravenous pyelogram exam shows bilaterally enlarged and flattened calyces which also appear to be increased in number. The renal pelvises bilaterally are normal in appearance.

IVP of congenital megacalyces
AP excretory phase image from a vintage intravenous pyleogram exam shows bilaterally an overall increased number of calyces in the kidneys. The calyces are enlarged and have a flattened appearance. The renal pelves are normal in size. The kidneys are draining bilaterally without obstruction into the bladder.