Colorenal fistula after renal tumour cryotherapy

Colo-renal Fistula in a Patient With Refractory Anemia and Recurrent Urinary Tract Infections: A Case Report and Review of the Literature

Although rare, colo-renal fistulas pose diagnostic challenges due to their varied presentations and etiologies. Here, we present a unique case of a woman with recurrent pyelonephritis, severe anemia, and unintended weight loss, who was eventually diagnosed with a colo-renal fistula. Delayed imaging following intraoperative fluoroscopy revealed the abnormal connection between the colon and upper urinary tract. The patient underwent nephrectomy and colon resection. This case report emphasizes the need for suspicion in diagnosing such fistulas and highlights their varied management. This case adds to the literature by illustrating an unusual presentation and underscores the complexity of diagnosis and treatment.

Complications of renal interventions: a pictorial review of CT findings

A number of potential vascular and non-vascular complications can arise from surgical, extracorporeal shock wave lithotripsy, radiotherapy and radiological renal interventions, including percutaneous image-guided biopsy and drainage. Computed tomography scan is usually one of the first and most important diagnostic imaging examinations requested when a potential complication is suspected. There are a wide range of common and uncommon potential complications from renal interventions. An understanding of underlying risk factors is important to reduce potential complications from renal intervention. Radiologists play a crucial role in recognising and diagnosing post-renal intervention complications on computed tomography scans, which could significantly improve the patient’s prognosis.

A Rare Complication Of Microwave Ablation For Renal Cell Carcinoma; Nephrocolic Fistula

INTRODUCTION

Nephrocolic fistula is a pathological connection between the kidney and colon. Percutaneous tumour ablation therapy is a rare cause of iatrogenic nephrocolic fistula in the literature.

CASE PRESENTATION

Interventional radiologists should be careful, especially in patients with repeated ablation. Granulation of tissue may lead to unexpected results secondary to tissue fragility and impedance changes.

CONCLUSION

In addition, we should keep in mind that there is decreasing hydro dissection benefit in cases with the previous ablation. As far as we know, this is the first case report of an iatrogenic ephrocolic fistula after microwave ablation for recurrence renal cell carcinoma.

Management of Left Staghorn Calculus With Colorenal Fistula

Fistula formation between the kidney and the colon is a rare occurrence. Colorenal fistulas have been reported after renal cryoablation, calculous pyonephrosis, and renal cell carcinoma. Fistula formation is reported in as many as 35% of patients with Crohn's disease. Crohn's-related urinary fistulas may include enterovesical, enteroureteral, rectourethral, urethrocutaneous, and entero-urachal fistulas. Here, we report a rare case of a patient who was found to have a left colorenal fistula in the setting of a left staghorn calculus and recurrent urinary tract infections with a question about the eventual definitive management of the patient.

Bowel injury complicating percutaneous cryoablation of large renal cell carcinoma

We report the case of a bowel injury, which occurred after the percutaneous cryoablation (PCA) of large renal cell carcinoma (RCC). A 50-year-old man with RCC measuring 47 mm in diameter. First, we performed transarterial embolization for the tumor, followed by PCA with hydrodissection, which displaced the small intestine from the iceball. The procedure was completed without any complication on the procedural day; however, the patient complained of appetite loss and abdominal pain 2 days after PCA. Computed tomography revealed a bowel injury at the small intestine adjacent to the tumor. After 7 days, ileus tube insertion, and fasting, the patient recovered from the bowel injury and was discharged 10 days after PCA. He underwent a second PCA because of a small recurrent renal tumor 5 months after the first PCA without complications. This case indicated that a bowel injury after PCA for RCC could be treated conservatively.

Miniaturized Intracavitary Forward-Looking Ultrasound Transducer for Tissue Ablation

OBJECTIVE

This paper aims to develop a miniaturized forward-looking ultrasound transducer for intracavitary tissue ablation, which can be used through an endoscopic device. The internal ultrasound (US) delivery is capable of directly interacting with the target tumor, resolving adverse issues of currently available US devices, such as unintended tissue damage and insufficient delivery of acoustic power.

METHODS

To transmit a high acoustic pressure from a small aperture (<3 mm), a double layer transducer (1.3 MHz) was designed and fabricated based on numerical simulations. The electric impedance and the acoustic pressure of the actual device was characterized with an impedance analyzer and a hydrophone. Ex vivo tissue ablation tests and temperature monitoring were then conducted with porcine livers.

RESULTS

The acoustic intensity of the transducer was 37.1 W/cm² under 250 V_pp and 20% duty cycle. The tissue temperature was elevated to 51.8 °C with a 67 Hz pulse-repetition frequency. The temperature profile in the tissue indicated that ultrasound energy was effectively absorbed inside the tissue. During a 5-min sonification, an approximate tissue volume of 2.5 × 2.5 × 1.0 mm³ was ablated, resulting in an irreversible lesion.

CONCLUSION

This miniaturized US transducer is a promising medical option for the precise tissue ablation, which can reduce the risk of unintended tissue damage found in noninvasive US treatments.

SIGNIFICANCE

Having a small aperture (2 mm), the intracavitary device is capable of ablating a bio tissue in 5 min with a relatively low electric power (<17 W).