Nephrobronchial fistula secondary to xantogranulomatous pyelonephritis

Souza, J. R. de; Rosa, J. Adorno; Barbosa, Ney C. B.

doi:10.1590/s1677-55382003000300009

Cited by 9 publications

(5 citation statements)

References 2 publications

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“…A Medline search revealed 16 cases of spontaneous NCF since 1983 and 24 cases of NBF since 1956. Furthermore, we found only two reported cases of coexistent NCF and NBF ( 4 , 5 ) and none for coexisting fistulisation to the psoas muscle, skin and bronchi.…”

Section: Discussionmentioning

confidence: 61%

“…There are several radiologic methods available for revealing the anatomical course of fistulae. In cases of renal fistulisation, a fistulogram and retrograde pyelography are usually the first step in the diagnostic procedure and are a good choice in cases where the spread of the disease is non-complicated ( 4 , 5 , 11 , 14 ). However, in cases where the spread is complex, as observed in this case, a CT in conjunction with fistulography is the best method to establish a diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Late complication of a renal calculus: fistulisation to the psoas muscle, skin and bronchi

2015

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Kidney disease presenting with cutaneous fistula is a rare condition. We present a case of a 90-year-old woman with dementia who had no prior urological problems and had a cutaneous fistula in the left lumbar region. A fistulogram and computer tomography examination revealed a large staghorn calculus with signs of xanthogranulomatous pyelonephritis in the left kidney and renal fistulisation to the psoas muscle, skin and bronchi. To our knowledge this is the first report in the literature of coexisting renal fistulisation to the psoas major muscle, skin and bronchi. This report illustrates how computed tomography in combination with fistulography can resolve the diagnostic dilemma that pertains to the complex spread of the disease in cases involving nephrocutaneous fistula. Furthermore, the report shows how a renal calculus, even asymptomatic, can cause a serious medical condition, and highlights the importance of early medical intervention.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Late complication of a renal calculus: fistulisation to the psoas muscle, skin and bronchi

2015

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“…Our patient experienced almost all of these symptoms (left-side abdominal mass, pain, weight loss, anemia and pyuria), as well as the additional, rarely seen complication of devascularization of the transverse and descending colon owing to compression by the extensive XGPN. Approximately one-third of XGPN cases have associated pathological findings such as psoas abscess, nephro-cutaneous fistula, nephro-bronchial fistula, reno-ileal fistula, renocolonic fistula and paranephric abscess [7][8][9][10] . In this patient, the XGPN was so extensive as to affect the intra-operative blood supply of the transverse and descending colon, thus causing the complicating ischemic colitis.…”

Section: Discussionmentioning

confidence: 99%

Ischemic colitis secondary to xanthogranulomatous pyelonephritis

Lai

Chou

et al. 2009

International Journal of Infectious Diseases

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Xanthogranulomatous pyelonephritis (XGPN) is an unusual suppurative granulomatous reaction to chronic infection. It often occurs in the presence of chronic obstruction from a calculus, stricture or tumor. XGPN clinically presents with abdominal mass, pain, weight loss, anemia and pyuria. Here, we report a case of a 50-year-old woman who had extensive XGPN complicated by a rarely seen unusual devascularization of the transverse and descending colon resulting in ischemic colitis owing to compression by a large mass. The abdominal mass was the largest to be reported to date worldwide. The etiologies, symptoms and signs, complications, diagnosis and treatment are also reviewed in this article.

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“…En la revisión de la literatura científica, los síntomas respiratorios, como tos, disnea y hemoptisis, fueron predominantes como forma de presentación y la mayoría de los pacientes presentaban comorbilidades renales, principalmente litiasis, lo cual concuerda con nuestra paciente. Con respecto a la vómica presentada, existen otros casos comunicados; 3,5,9,12 sin embargo, en ninguno de ellos, esta condicionó una situación de riesgo vital.…”

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Fístula nefrobronquial en paciente pediátrico. Caso clínico

R³

et al. 2014

Arch Argent Pediat

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Presentación de casos clínicos RESUMENLa fístula nefrobronquial es una complicación infrecuente de las infecciones renales, que ocurre habitualmente en pacientes adultos con pielonefritis xantogranulomatosa. Comunicamos el caso de una paciente de 12 años con antecedentes de mielomeningocele operado e infección urinaria recurrente, quien consultó con historia de cuatro semanas de fiebre, tos y disnea. Ingresó en shock séptico y presentó inundación de la vía aérea por pus, que le ocasionó episodio de asistolia. Mediante tomografía computarizada de abdomen, se diagnosticó extensa colección perirrenal izquierda. Se efectuó un drenaje percutáneo, que dio salida a pus y aire. TAC de tórax y abdomen mostró fístula transdiafragmática entre la base pulmonar izquierda y colección intraabdominal. Se realizó nefrectomía total. La paciente mostró mejoría progresiva poscirugía y regresión total de la sintomatología. Este infrecuente caso clínico en niños ilustra la importancia del diagnóstico precoz de infección urinaria en pacientes con patologías asociadas y de presentar un elevado índice de sospecha ante una complicación potencialmente letal. Palabras clave: pielonefritis crónica, fístula nefrobronquial, urolitiasis, infección urinaria. ABSTRACTNephrobronchial fistula is a rare complication of kidney infections, usually occurring in adult patients with xanthogranulomatous pyelonephritis and very occasionally in children. We reported a 12-year-old girl, with a history of myelomeningocele and recurrent urinary tract infection, who presented with a four-week fever, cough and dyspnea, developing septic shock and presenting flood of airway by pus which caused cardiac arrest. A diagnosis of left perirenal extensive collection was established by abdominal computed tomography (CT). The patient first had antibiotic therapy and percutaneous drainage was performed draining pus and air. Thoracic and abdominal CT scan was performed corroborating transdiaphragmatic fistula. Total nephrectomy was performed. The patient showed gradual improvement after surgery and total regression of symptoms. Pathologic examination concluded chronic pyelonephritis. Fístula nefrobronquial en paciente pediátrico. Caso clínico Nephrobronchial fistula in pediatric patient. Case reportThis case report illustrates a rare complication in children, the importance of early diagnosis of urinary tract infection in patients with comorbidities and of exhibiting a high index of suspicion to a potentially lethal complication.

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Nephrobronchial fistula secondary to xantogranulomatous pyelonephritis

Abstract: This clinical case illustrates the natural history of nephrobronchial fistula, the importance of clinical history for diagnosis and the relevance of early treatment of renal lithiasis.

Cited by 9 publications

References 2 publications

Late complication of a renal calculus: fistulisation to the psoas muscle, skin and bronchi

Late complication of a renal calculus: fistulisation to the psoas muscle, skin and bronchi

Ischemic colitis secondary to xanthogranulomatous pyelonephritis

Fístula nefrobronquial en paciente pediátrico. Caso clínico

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