Currently, the optimal approach to a caliceal diverticulum appears to be direct puncture into the diverticulum with subsequent dilation and stenting of the narrow ostium with a large nephrostomy tube. However, further maneuvers might be necessary in cases of large volume caliceal diverticula. We describe a patient with a large caliceal diverticulum (7.5 cm.) in whom percutaneous endoscopic fulguration was used successfully as an additional technique to assure obliteration of the diverticulum.
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