Abstract
Nephroenteric fistulas can be secondary to different etiologies, the most common of which are pyelocolic fistulas. The absence of pathognomonic symptoms and the heterogeneity of presentation can sometimes result in a delay in diagnosis. We report on three cases: a pyelo-duodenal fistula secondary to kidney stones and subsequent pyonephrosis, a pyelocolic fistula due to inveterate ureteral stones with hydropyonephrosis, and a rare case of posttraumatic pyelocolic fistula. All patients were treated with radical nephrectomy and resection of the involved intestinal tract. Fistulas of the kidney with the gastrointestinal tract are complex not only for the surgical treatment, which is mandatory in the majority of cases, but also for clinical and instrumental diagnosis. Severe infection is a major concern due to the admixture of the enteric bacterial flora with the urinary tract. Nephroenteric fistulas require skilled surgical procedures, close control of the septic risk, management of patient's overall medical condition, and balance between invasive and conservative approach.
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References
Brust RW, Morgan AL (1974) Renocolic fistula secondary to carcinoma of the colon. J Urol 111:439–440
Farina LA Caparrós J, Palou J, Rousaud A (1992) Renogastric fistula. J Urol 147:677–679
Bissada NK, Cole AT, Fried FA (1973) Reno-alimentary fistula: an unusual urological problem. J Urol 110:273–276
Matsuoka Y, Arai G, Ishimaru H, Takagi K, Aida J, Okada Y (2006) Xanthogranulomatous pyelonephritis with a renocolic fistula caused by a parapelvic cyst. Int J Urol 13(4):433–435
Blatstein LM, Ginsberg PC (1996) Spontaneous renocolic fistula: a rare occurrence associated with renal cell carcinoma. J Am Osteopath Assoc 96(1):57–59
Atalla M, Tajkarimi K, Vinh D, Guarnaccia SP (2009) Pyeloduodenal fistula. J Urol 181:2733–2734
Bruni R, Bartolucci R, Biancari F, Santoro M (1995) Nephro-jejunal fistula associated with nephro-cutaneous fistula. Minerva Chir 50(5):519–521
Schieroni R, Dogliani M, Acanfora F, Gandini G, Poy F, Borello G et al (2002) Renal stone ileus in xanthogranulomatous pyelonephritis. A case report. Minerva Chir 57(5):689–394
Rometti A, Raymond G, Toubol J, Garbit JL, Pastorini P, Kalachnikoff P et al (1977) Apropos of a case of tuberculous renocolic fistula. J Urol Nephrol (Paris) 83(10-11):889–892
Gimenez E, Raman JD, Lieberman M, Vaughan ED Jr (2008) Cutaneous renocolic fistula associated with diverticulitis. Can J Urol 15(4):4191–4193
McDougal WS, Persky L (1972) Traumatic and spontaneous pyelo-duodenal fistula. J Trauma 12:665–670
Ginsberg DA, Stein JP, Grossfeld GD, Tarter T, Skinner DG (1996) Traumatic Pyeloduodenal fistula: a case report and review of the literature. Urol 47(4):588–591
Leemans J, Kotowicz A, Parmentier P, Bertrume M, Schockert J (1980) Low pyelonephrotic ectopic kidney complicated by a digestive fistula. A clinical observation. Acta Urol Belg 48(3):353–357
Morris DB, Siegelbaum MH, Siegelbaum MH, Pollack HM, Kendall AR, Gerber WL (1991) Renoduodenal fistula in a patient with chronic nephrostomy drainage: a case report. J Urol 146:835–837
Bleacher JC, Bohne GB, Decter RM, Conter RL (1993) Pyeloduodenal fistula: a previously undescribed complication of Stamm gastrostomy. J Pediatr Surg 28:1579–1581
Neustein P, Barbaric ZL, Kaufman JJ (1986) Nephrocolic fistula: a complication of percutaneous nephrostolithotomy. J Urol 135:571–573
Vanderbink BA, Rastinehad A, Caplin D, Ost MC, Lobko I, Lee BR (2007) Successful conservative management of colorenal fistula after percutaneous cryoablation of renal cell carcinoma. J Endourol 21:726–729
Wysocki JD, Joshi V, Eiser JW, Gill N (2010) Colo-renal fistula: an unusual cause of hematochezia. World J Gastrointest Pathophysiol 1:106–108
Parvey H, Cochran S, Payan J, Goldman S, Sandler CM (1997) Renocolic fistulas: complementary roles of computed tomography and direct pyelography. Abdom Imaging 22:96–99
Lang EK, Fritzche P (1990) Fistulas of the genitourinary tract. In: Pollack HM (ed) Clinical urography: an atlas and textbook of urologic imaging. Saunders, Philadelphia, pp 2579–2583
Culkin DJ, Wheeler JS Jr, Canning JR (1985) Nephroduodenal fistula: a complication of percutaneous nephrolithotomy. J Urol 134:528–530
Alster C, Zantut L, Lorenzi F, Marchini GS, Onofrio BJ, Nakashima AA et al (2007) An unusual case of pneumoperitoneum: nephrocolic fistula due to a giant renal staghorn calculus. Br J Radiol 80:e1–e3
Desmond J, Evans S, Couch A, Morewood DJ (1989) Pyeloduodenal fistula. A report of two cases and review of the literature. Clin Radiol 40:267–270
Poon JT, Tam PC, Chu KM (2003) Pyeloduodenocolic fistula. Asian J Surg 26:186–188
Kim S, Weiser A, Nadler R (2000) Nephroenteric fistula treated with fulguration of the fistulous tract. J Endourol 14:443–445
Morris SB, Knight MJ, Shearer RJ (1994) Pyelo-duodenal fistula: a new method of closure. Br J Urol 73:464–465
Abet D, Gamain J, Pietri J (1981) Broncho-reno-cutaneous fistula. Etiopathogenicity and possible therapy. A case report. J Chir (Paris) 118(6-7):417–419
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Campobasso, D., Granelli, P., Maestroni, U. et al. Are Nephroenteric Fistulas Only a Surgical Trouble?. Indian J Surg 77, 222–225 (2015). https://doi.org/10.1007/s12262-014-1046-1
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DOI: https://doi.org/10.1007/s12262-014-1046-1