HighlightsAcute retrograde jejunogastric intussusception is a rare event.It presents as sudden onset epigastric pain with mass and vomiting in a patient who underwent previous gastric surgery.The treatment of acute jejunogastric intussusception is prompt surgery.Early surgical intervention prevents vascular compromise and bowel gangrene.

A 22-year-old known case of 45XO/46XY mixed gonadal dysgenesis, reared as a male, presented with complaints of suprapubic and left iliac fossa pain for the past 1 month. The patient underwent laparoscopic right orchidectomy (streak) + Mullerian remnant excision + left orchidopexy + first-stage hypospadias repair 10 years back. Contrast-enhanced computed tomography showed a large complex cyst in the left side of the pelvis and rectovesical space. Excision of the cystic structure was done along with left orchidectomy. Histopathological examination revealed features of Mullerian remnants (endometrial glands and cervix) in the cystic structure. The importance of this case report is to emphasize the fact that the Mullerian remnants tend to enlarge in size over time and become symptomatic and may require a surgical removal at a later date as in our case.

Renal calyceal diverticulum are outpouching from renal calyx or pelvis into the renal cortex lined by transitional cell epithelium. We report a case of 35 years old male with history of accidental fall from bike, who presented with persistent right loin pain and hematuria. CT Urogram showed multiple large right renal cysts (BOSNIAK II). Patient was planned laparoscopic renal cyst deroofing. Due to suspicion of calyceal diverticulum, an intraoperative Retrograde Pyelogram (RGP) was done which showed calyceal diverticulum. Laparoscopic calyceal diverticulotomy with closure of communication was done. If only a cyst deroofing was done considering the CT finding alone, it would have ended up in post-operative complication of urinoma which may require a re-surgery. This case report emphasizes the importance of anticipating calyceal diverticulum and intraoperative attempts in the form of doing RGP to identify calyceal diverticulum which mimic renal cyst regardless of CT finding in suspected cases. Keywords: Calyceal diverticulum; large renal cyst; retrograde pyelogram; laparoscopic calyceal; Diverticulotomy.