Presentation
Bilateral dull, moderate loin pain and heaviness.
Patient Data










Both kidneys have normal limit size.
Dilatation of all calyxes bilaterally without obvious obstruction.
Normal renal pelvis in both sides.
No hyperdense stone or calcification seen within kidneys, ureters and urinary bladder.
Case Discussion
Congenital megacalycosis also called Puigvert Disease is a rare condition, the most rare in our case is the bilaterality. It is characterized by non obstructive increased volume (distention) and number of renal calyces.
The exact etiology of the condition is unknown, however, it is supposed to be due to underdeveloped renal papilla that account for bulging, and malformed calyces.
Usually, the pathology is symptom-less unless complicated by infection or stone formation secondary to stasis of urine within capacious calyces.
In our case, midstream urine examination revealed presence of urinary tract infection as a cause of patient's complaint.