A case of diagnostic difficulty facing the patient with colonic polyposis secondary to Peutz–Jeghers syndrome, but without family history and pathognomonic clinical features of the disease, is illustrated. The exams, including biopsy, led to diagnostic uncertainty and the definitive diagnosis was characterized in therapeutic of exception.

Introduction and PurposeMany are the anatomical variations of the pyelocaliceal system, which influence the arterial irrigation and venous drainage. This study adopted a classification given by Sampaio in “Anatomia Renal para Urologia”. The system is divided in: Type A‐I has the mesorenal region drained by chalices from the superior or inferior caliceal group. Type A‐II has the mesorenal region drained by crossed chalices from both superior and inferior caliceal groups. Type B‐I has the mesorenal region drained by an independent caliceal group. Type B‐II has small chalices that drain the mesorenal region directly to the renal pelvis. The study aims to describe the structure of the pyelocaliceal system and its variations. Compare findings with those found in literature.MethodsKidneys obtained from adults that belong to the Morphology Department of Faculdade de Ciênicas Médicas da Santa Casa de São Paulo were injected with resin through the ureter and later corroded by acid. Kidneys obtained from someone who had nefropathy were excluded.Results52 kidneys were obtained. 39.6% were type A‐I. 12.5% were type A‐II. 18.8% type B‐I and 29.2% type B‐II.ConclusionResults were similar to the ones found in Brazilian population studies. Many are the anatomic variations of the pyelocaliceal system and they must be considered especially involving surgical procedures.