Presentation
Previous upper urinary tract infection. No ultrasound abnormalities. Vesicoureteral reflux suspected.
Patient Data
Age: 8 years
Gender: Male
From the case:
Hutch diverticulum
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In early and complete filling images acquired at rest, left first-grade vesicoureteric reflux was found. The images acquired in voiding reveal Hutch diverticula on both sides of the bladder with an actual fourth grade left vesicoureteric reflux. No evidence of posterior urethral valves.
- early filling: no defect suggestive of ureterocele, first grade left vesicoureteral reflux
- complete filling: normal contour and capacity of the bladder, no vesicoureteral reflux at rest
- lateral projection: normal bladder contour, no vesicoureteral reflux
- bladder voiding: bilateral Hutch diverticula, fourth grade left vesicoureteral reflux, normal urethra
- post-void: residual volume in bladder and left ureter
Case Discussion
In 1961, John Hutch described a primary type of bladder diverticula.
The Hutch diverticula are:
- intermittent, usually appear during voiding
- located near the ureterovesical junction
- associated with vesicoureteral reflux
VUR has always to be evaluated both in filling and in voiding.
Ureterocele is a submucosal cystic dilation of the terminal ureter, usually intravesical.
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