Description

      In a 54-year-old woman with Autosomal Dominant Polycystic Kidney Disease (ADPKD), stage 3B chronic kidney disease, arterial hypertension, and dyslipidaemia, contrast-enhanced Magnetic Resonance Imaging (MRI) of the abdominal cavity was done due to the ultrasound suspicion of solid mass in the left polycystic kidney. MRI ruled the mass out, but showed a diverticulum in subcardial gastric area (Figure 1).

     Gastric diverticula are very rare findings; they are observed in 1-11:10000 of upper gastrointestinal endoscopic procedures. In the majority of cases, they are asymptomatic, and do not require further diagnostics and treatment [1]. That was a case in the reported patients.

     ADPKD is a systemic disease with various extra-renal manifestations, including connective tissue disorders [2]. In effect, association of ADPKD with colonic diverticular disease [3], as well as duodental diverticula [4] was proposed. In line with these findings, we suppose that gastric diverticulum may belong to the spectrum of extra-renal manifestations of ADPKD.

References

1. Laskaratos FM, El-Mileik H. Gastric diverticulum of the antrum: An unususal endoscopic finding. Clin Case Rep. 2018; 6: 2515-2516.
2. Ul Haque A, Moatasim A. Adult polycystic kidney disease: A disorder of connective tissue? Int J Clin Exp Pathol. 2008; 1: 84-90
3. Mikolajczyk AE, Te HS, Chapman AB. Gastrointestinal Manifestations of Autosomal-Dominant Polycystic Kidney Disease. Clin Gastroenterol Hepatol. 2017; 15: 17-24.
4. Kumar S, Adeva M, King BF, Kamath PS, Torres VE. Duodenal diverticulosis in autosomal dominant polycystic kidney disease. Nephrol Dial Transplant. 2006; 21: 3576-3578.