Spontaneous nephrocutaneous fistula due to xanthogranulomatous pyelonephritis with secondary enterocutaneous fistula: a rare case report

Chronic infection, especially in the setting of obstruction like calculous disease, may result in the fistula tract development of fistula tract from kidney to the other proximal organs. However, nephrocutaneous fistula is a rare complication, and the primary cause of its development is previous surgical intervention, trauma, or malignancy. Our case was a 26-year-old Afghan man with xanthogranulomatous pyelonephritis (XGP) resulted in spontaneous nephrocutaneous fistula. The patient underwent radical nephrectomy. Our case shows that previous surgery is not the only cause of fistula. After surgery, he presented with secondary enterocutaneous fistula due to surgery or chronic underlying inflammation. After systemic antibiotic therapy and total parenteral nutrition, he became well and discharged from the hospital. As a result, XGP is a rare subtype of chronic pyelonephritis that requires immediate evaluation and early diagnosis. Patients should be considered for possible complications such as fistulas. Physicians should be aware of this issue for appropriate diagnosis and treatment.

Communicating Fistula Between Colocutan and Nephrocutan With Renal Stones and Renal Replacement Lipomatosis. A Case Report

Colocutaneous fistula with nephrocutaneous fistula is a rare condition. Renal replacement lipomatosis is the result of the atrophy and destruction of renal parenchyma. We report a 60-year-old male with intermittent drainage mucus and fluid from ulcer of his right lumbar region. Renal ultrasound and plain abdominal X-ray revealed a chronic parenchymal disease with stone of the right kidney. Fistulography showed a fistula tract connecting the skin and the right pelvicalyceal system and the colon. Computerized tomography demonstrated a renal calculus with a massive fatty proliferation. The patient was planned for right nephrectomy and excision of the sinus tract.

Unusual case of nephrocutaneous fistula - Our experience

A rare case of nephrococutaneous fistula due to spontaneous expulsion of renal calculi is described. A 45-year-old man presented with urinary leakage from an ulcer over the left lumbar region for the last 3 months after a history of spontaneous expulsion of stones from this area. Ultrasonography abdomen revealed a small contracted kidney with multiple calculi in the kidney and renal pelvis, sinus tract from the lower pole of the left kidney with a ruptured calyceal calculus in the sinus tract. CT urography revealed a non excreting left kidney with multiple renal calculi, with hyperdense collection in the renal parenchyma extending to the subcutaneous tissue and left lung suggesting a xenthogranulomatous pyelonephritis (XGP). We performed a left-sided simple nephrectomy with excision of the fistulous tract. Histopathological examination revealed XGP. There have been a few case reports of XGP forming nephrocutaneous fistula in the back.

Chronic spontaneous nephrocutaneous fistula associated with renal replacement lipomatosis

Chronic spontaneous nephrocutaneous fistula is a rare renal disease. Renal replacement lipomatosis (RRL) is the result of the atrophy and destruction of renal parenchyma with massive increases in the amount of fat in the sinus and perirenal space. The 2 conditions can be associated because they may have the same etiology. Indeed, urolithiasis is the most common cause of these diseases. We report a case of chronic nephrocutaneous fistula associated with RRL due to both urolithiasis and renal tuberculosis.