Though very rare, they may lead to morbidity in the form of septicemia, peritonitis, abscess formation, and nephrocolic or colocutaneous fistula.
Although the incidence of this complication is very low (i.e., 0.3 to 1% of cases) as reported by Skolarikos and de la Rosette,(9) colonic injury may produce dangerous morbidity in the form of septicemia, peritonitis, abscess formation, and nephrocolic or colocutaneous fistula.
Nephrocolic fistula complicating percutaneous nephrostomy.
Nephrocolic fistula: A complication of percutaneous nephrostolithotomy.
We present one such case of spontaneous nephrocolic fistula complicating XGPN.
Key words: Nephrectomy; nephroenteric fistula; nephrocolic fistula; renocolic fistula; xanthogranulomatous pyelonephritis.
Colonic perforation is one of the most dangerous and rare complications of PCNL, occurring in about 0.3% of procedures.[sup.4] Untreated colonic perforation may lead to renal abscess, nephrocolic or colocutaneous fistula, peritonitis and sepsis.[sup.4,5] However, there are few reports on the risk factors and management of colonic injury during PCNL.
This includes separating the nephrocolic communication, including double J stent insertion for adequate urinary drainage and retraction of the nephrostomy tube from the pelvicalicial system into the colon as a percutaneous colostomy tube.
In 1993, Melvin and colleagues were the first to describe a renocolic fistula due to an abdominal trauma by firearm.[sup.1] In 2001 Herbert and colleagues reported on the second case.[sup.5] After searching based on Pubmed using keywords (i.e., renocolic, nephrocolic, fistula, trauma and gunshot), we found that our case is the third report.
Successful conservative management of nephrocolic fistula.