Treatment of a high output nephrocutaneous urine leak following treatment of a giant calyceal diverticulum in a child

Calyceal diverticula are non-secretory transitional-epithelium lined cavities that are connected to the collecting system through a small ostium. They are rarely seen in young children. Although most remain asymptomatic, the presence of stagnant urine can result in infection, stone formation and pain. Treatment may consist of percutaneous ablation or open surgical excision. Failure of the ostium to completely seal can result in a persistent leak. We present a case of a massive calyceal diverticulum in a child who developed a postsurgical nephrocutaneous fistula recalcitrant to conservative management that was successfully managed with injection of fibrin glue.