Pelvicaliectasia
Pelvicaliectasia is dilation of the renal pelvis and calyces seen on imaging studies. It is a descriptive term for urinary tract dilatation rather than a single diagnosis.
Imaging definition and typical descriptors
Pelvicaliectasia is commonly reported on ultrasound and reflects impaired urine drainage from the kidney toward the ureter. Severity is often characterized by the extent of calyceal/renal pelvis dilation and, in some reporting systems, the presence or size of associated hydronephrosis.
Common causes
Pelvicaliectasia most often results from obstruction to urine flow or from transient functional/physiologic urinary stasis. Examples include:
- Ureteropelvic junction obstruction (congenital or acquired).
- Ureteral obstruction from stones, stricture, or external compression.
- Vesicoureteral reflux with recurrent urine backup.
- Pregnancy-related or other physiologic conditions that increase urinary tract dilation.
- Neurogenic bladder or other causes of impaired bladder emptying that lead to back-pressure.
Clinical significance
Pelvicaliectasia may be benign and transient when due to temporary stasis. Persistent or progressive dilation can indicate clinically important obstruction or reflux and may increase risk of recurrent infection and kidney injury.
Evaluation
Evaluation typically focuses on identifying the cause and assessing whether renal function and drainage are affected. Common next steps include:
- Urinalysis and urine culture when infection is suspected.
- Serum creatinine and estimated glomerular filtration rate when kidney function assessment is needed.
- Repeat ultrasound to assess progression or resolution.
- Additional imaging to define anatomy and drainage when obstruction is suspected (for example, a renogram for functional drainage or other cross-sectional imaging based on age and clinical context).
Management principles
Management depends on etiology and whether there is obstruction, recurrent infection, worsening dilation, or declining renal function. Options may include observation with surveillance for mild/stable cases, infection treatment when present, and procedural or surgical management for confirmed clinically significant obstruction or high-risk reflux.
When urgent evaluation is indicated
Urgent evaluation is indicated when pelvicaliectasia is accompanied by red flags for complications, including suspected urinary tract infection with systemic symptoms or severe pain, or when laboratory evidence suggests impaired kidney function.
Key takeaways
Pelvicaliectasia denotes renal collecting-system dilation on imaging. Further workup is directed at determining whether the dilation is transient versus driven by obstruction, reflux, or impaired drainage.