Abstract
Hutch diverticulum (HD) is a rare congenital condition characterized by the herniation of the bladder’s mucosa and submucosa through the detrusor muscle fibers, encountered more commonly in children. An association between HD and situs inversus totalis (SIT) in an elderly patient has not been reported previously in the literature. We present the case of a 70-year-old male referred for routine bone scintigraphy as part of staging for lung carcinoma; thoraco-abdomino-pelvic computed tomography confirmed the staging and revealed a total transposition of the thoracic and abdominal organs, confirming SIT. This case highlights the exceptional association of HD and SIT, which was discovered incidentally in an elderly patient during metastatic staging for lung cancer. It underscores the importance of careful interpretation of scintigraphic findings, particularly when unusual radiotracer uptake is observed.
Keywords:
Bone scintigraphy, Hutch diverticulum, situs inversus totalis
Ethics
Informed Consent: Written informed consent was obtained from the patient for publication of this case report and accompanying images.
Authorship Contributions
Concept: L.E.A., I.G., Design: L.E.A., I.G., Data Collection or Processing: L.E.A., I.G., Analysis or Interpretation: L.E.A., H.G., A.M., I.G., Literature Search: L.E.A., I.G., Writing: L.E.A.
Conflict of Interest: No conflicts of interest were declared by the authors.
Financial Disclosure: The authors declare that this study has received no financial support.
References
1Hutch JA. Saccule formation at the ureterovesical junction in smooth walled bladders. J Urol. 1961;86:390-399.
2Telli O, Guclu AG, Haciyev P, Burgu B, Gogus C. A rare entity in adults: bilateral Hutch diverticulum with calculi. Can Urol Assoc J. 2015;9:E343-E344.
3Palmero Martí JL, Ramirez Backhaus M, Alvarez Barrera A, Amoros Torres A, Benedicto Redon A. Hutch bladder diverticula: a very uncommon entity in adults. Arch Esp Urol. 2012;65:636-639.
4Sammour ZM, Gomes CM, de Bessa J Jr, Pinheiro MS, Kim CA, Hisano M, Bruschini H, Srougi M. Congenital genitourinary abnormalities in children with Williams-Beuren syndrome. J Pediatr Urol. 2014;10:804-809.
5Chen J, Liu F, Tian J, Xiang M. Laparoscopic bladder diverticulectomy in a child with situs inversus totalis: a case report and literature review. Front Surg. 2022;9:1009949.
6Fulcher AS, Turner MA. Abdominal manifestations of situs anomalies in adults. Radiographics. 2002;22:1439-1456.