An abscess that wasn't: renal calyceal diverticulum in a student Naval aviator

Abstract

The authors report a case of a 24-yr-old female Navy student pilot who presented with pyelonephritis, and on workup, was found to have two diverticula arising from calyces in her left kidney. Her infection resolved after several weeks of antibiotic therapy. She was granted a waiver to return to flight status based on the judgment that her risk of recurrent infection, sudden incapacitation, future need of surgery, and compromise of mission effectiveness were acceptably low. She has remained asymptomatic after more than 48 mo of follow-up. Renal calyceal diverticulum has not previously been discussed in the literature of aerospace medicine. The definition, anatomy, possible etiologies, epidemiology, presentation, treatment options, and aeromedical disposition, including human-machine interface issues, for calyceal diverticula are discussed. Aviators with calyceal diverticula are at increased risk of urinary tract infection and other complications; aeromedical disposition should rest on evaluation of such risk on a case-by-case basis.