Indian Journal of Urology Users online:756  
IJU
Home Current Issue Ahead of print Editorial Board Archives Symposia Guidelines Subscriptions Login 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size


 
CASE REPORT
Year : 2000  |  Volume : 17  |  Issue : 1  |  Page : 64-65
 

Spontaneous reno-colic fistula


Division of Urology, Kasturba Medical College, Manipal, India

Correspondence Address:
K Sasidharan
Division of Urology, Kasturba Medical College, Manipal - 576 119
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions

 

Keywords: Reno-colic Fistula; Tuberculosis


How to cite this article:
Parasher R, Sasidharan K. Spontaneous reno-colic fistula. Indian J Urol 2000;17:64-5

How to cite this URL:
Parasher R, Sasidharan K. Spontaneous reno-colic fistula. Indian J Urol [serial online] 2000 [cited 2019 Oct 18];17:64-5. Available from: http://www.indianjurol.com/text.asp?2000/17/1/64/41026



   Introduction Top


Reno-colic fistula occurs rarely and was first described in 460 B.C. by Hippocrates. Since that time about 120 cases have been reported. The occurrence of this condi­tion has in recent times declined due to prompt treatment of renal pathologies before the stage of fistula formation. We herein present a case of reno-colic fistula secondary to renal tuberculosis.


   Case Report Top


A 42-year-old female presented with recurrent left flank pain, diarrhoea and episodic low-grade fever of 6 months duration. There was preceding history of pulmonary tu­berculosis.

On evaluation she was found to have mild anaemia and elevated ESR. Urine culture grew E.coli Serum creatinine and blood urea were within normal limits.

An intravenous urogram disclosed a poorly visualised left kidney and normal right kidney. Left retrograde ure­terogram showed an irregular and marginally dilated pelvicalyceal system in a relatively contracted kidney. The ureter was unremarkable. Her history of diarrhoea man­dated a Barium study and colonoscopy. During the former study barium was seen entering the left pelvicalyceal sys­tem [Figure 1], and the post evacuation film showed persist­ence of barium in the kidney [Figure 2]. The colonoscopy disclosed a puchered and spastic segment close to the splenic flexure indicating the site of the fistula.

The patient underwent left nephrectomy along with seg­mental resection of colon with subsequent luminal resto­ration with colo-colic anastomosis. Her postoperative period was uneventful and she continues to remain well till date.

The histopathology of the composite specimen of left kidney and colonic segment was in consonance with re­nal tuberculosis.


   Discussion Top


Among reported cases of reno-alimentary fistulas in lit­erature reno-colic fistulas were most common. Leading causes of such fistulization are chronic renal diseases (spontaneous fistulas) and severe renal trauma (penetrating and non-penetrating. [1],[2],[3] In the current setting PCNL can also lead to reno-colic fistulas. [5] Other rare causes are diverticular and inflammatory bowel disease and even carcinoma. [4] Tuberculosis remains the principal cause of spontaneous colorenal fistulas. The involved kidney is non­functioning and hence recommended treatment is nephrec­tomy with excision of the involved colonic segment and subsequent luminal restoration with end-to-end anastomo­sis.

We concede that in recent times prompt multidrug tuber­cular chemotherapy has significantly retarded the inci­dence of spontaneous reno-colic fistula due to the disease. However, renal tuberculosis being endemic in our coun­try, we can not dismiss altogether an insidious develop­ment of such fistulas in non-functioning retained kidneys.

 
   References Top

1.Bissada NK, Cole AT, Fried FA. Reno-alimentary fistula: An un­usual urological problem. J Urol 1973: 110: 273.  Back to cited text no. 1    
2.Arthur GW, Morris DG. Reno-alimentary fistula. Br J Surg 1966: 53: 396.  Back to cited text no. 2    
3.Melvin WS, Burak WE, Flowers JL, Donald SG. Reno-colic fistula following primary repair of the colon: a case report. J Trauma 1993: Vol 35 No. 6: 956.  Back to cited text no. 3    
4.Burst RW Jr, Morgan AL. Reno-colic fistula secondary to carci­noma of the colon. J. Urol 1974; 111: 439.  Back to cited text no. 4    
5.Neustein P, Barbaric ZL, Kaufman JJ. Nephrocolic fistula: A com­plication of percutaneous nephrolithotomy. J Urol 1986; 135: 571.  Back to cited text no. 5  [PUBMED]  


    Figures

  [Figure 1], [Figure 2]



 

Top
Print this article  Email this article
Previous article Next article

    

 
   Search
 
   Next article
   Previous article 
   Table of Contents
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    [PDF Not available] *
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    Introduction
    Case Report
    Discussion
    References
    Article Figures

 Article Access Statistics
    Viewed1559    
    Printed47    
    Emailed1    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal

HEALTHWARE INDIA