2022 Volume 55 Issue 2 Pages 140-146
We report a case of renocolic fistula caused by xanthogranulomatous pyelonephritis. A 65-year-old woman underwent abscess drainage for left perinephric abscess associated with renal stone. Her condition improved, but three months after drainage she was hospitalized due to relapse of perirenal abscess. Abdominal CT showed a staghorn calculus in the left renal pelvis complicated by perinephric abscess, and percutaneous abscess drainage was repeated. On day 15 of hospitalization, a contrast study via a drainage tube revealed a fistula from the left kidney into the descending colon. The patient underwent nephrectomy combined with left hemicolectomy and en bloc removal of the site of inflammation. Microscopic findings showed infiltration of lymphocytes and foamy lipid-laden macrophages. The final diagnosis was renocolic fistula caused by xanthogranulomatous pyelonephritis. Septic shock occurred during the perioperative period, but the postoperative course was uneventful and the patient was discharged 9 days after the operation.
