Hutch diverticulum

A Hutch diverticulum is a congenital bladder diverticulum, seen at vesicoureteric junction. 

Congenital bladder diverticulum, not associated with posterior urethral valve or neurogenic bladder, occur almost exclusively in boys. These kind of diverticula are seen in ~2% of cases 3.

Urinary tract infection, incontinence, or urinary retention are the most common presentations.

Hutch diverticulum are commonly seen with vesicoureteric reflux (VUR), because the normal oblique insertion of the ureter is disrupted.

Associations
Fluoroscopy

On micturating cystourethrogram contrast filled outpouchings arising from urinary bladder arising at vesicoureteric junction are seen. VUR is also often seen.

Ultrasound

Round or oval anechoic fluid collections arising from base of urinary bladder or around ureteric orifice 1.

Incidentally detected diverticulum, usually does not require any therapy. If associated with VUR, recurrent UTI or obstruction, it should be excised. However, because of risk of development of carcinoma, many surgeons argue prophylactic surgery in all cases. Hutch diverticulum are prone to spontaneous rupture, as well as post-surgical relapse.

  • "bladder ears"
    • these are transient outpouching normally seen in infants, and represent normal protrusions of urinary bladder into the inguinal rings
    • lateral VCUG usually clarifies the diagnosis
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Article Information

rID: 16295
System: Urogenital
Section: Pathology
Synonyms or Alternate Spellings:
  • Hutch diverticulae
  • Periureteral diverticulum
  • Hutch diverticula

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Cases and Figures

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    Case 1: VCUG
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    Case 1: ultrasound
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    Case 2
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    Case 3
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    Bladder voiding: ...
    Case 5
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