Spontaneous nephrocutaneous fistula

Abstract

Spontaneous renal fistula to the skin is rare. The majority of cases develop in patients with antecedents of previous renal surgery, renal trauma, renal tumors, and chronic urinary tract infection with abscess formation.We report the case of a 62-year old woman, who complained of urine leakage through the skin in the lumbar region for 2 years. She underwent a fistulography that revealed drainage of contrast agent to the collecting system and images suggesting renal lithiasis on this side. The patient underwent simple nephrectomy on this side and evolved without intercurrences in the post-operative period.Currently, the occurrence of spontaneous renal and perirenal abscesses is extremely rare, except in patients with diabetes, neoplasias and immunodepression in general.

Spontaneous nephro-cutaneous fistula with pyonephrosis in two dogs: two case reports

“…In humans, spontaneous renal fistula to adjacent organs is not an uncommon phenomenon; however, a spontaneous communication between the kidneys and skin is rare (Antunes et al 2004). Lobetti and Irvine-Smith (2006) first reported a nephrocutaneous fistula in a dog with a history of previous renal trauma.…”

Hypodermite lombaire abcédée révélant une pyonéphrose

“…Contrairement à notre cas, le tableau d'hypodermite bactérienne, avec ou sans foyer suppuratif profond sousjacent, est souvent marqué par des signes cliniques importants de sepsis [3,[5][6][7][8] et apparaît parfois dans un contexte d'immunodépression associée, comme lors de tumeurs malignes [3,6]. Les manifestations cutanées des pyonéphroses sont surtout des fistules [9], parfois associées à un abcès sous-cutané [10]. Elles surviennent habituellement aussi sur un terrain débilité (antécédents de cancer, diabète.…”

Nephro-cutaneous fistula in a dog : clinical communication

“…However, the spontaneous communication between kidney and skin is rare and few cases are described in the literature 2,3,4,5 . The majority of cases reported in the medical literature are associated with chronic urinary tract infection secondary to renal stones 2,3,4,5 . Fistulas can develop between the kidney and the pleural cavity, lungs and bronchia, bowel, and skin.…”

“…Fistulas can develop between the kidney and the pleural cavity, lungs and bronchia, bowel, and skin. The latter are, however, rare, and whenever they occur, they typically involve patients with a past history of renal surgery 2,3 . The majority of fistulas present with spontaneous drainage through the lumbar region following those points with lowest resistance such as the lumbar triangle and the lumbar quadrilateral, establishing a fistulous pathway that communicates the perirenal tissues and collecting system with the external environment 1,3 .…”

“…The majority of fistulas present with spontaneous drainage through the lumbar region following those points with lowest resistance such as the lumbar triangle and the lumbar quadrilateral, establishing a fistulous pathway that communicates the perirenal tissues and collecting system with the external environment 1,3 . In humans, therapeutic approaches are based on renal function and on the patient's ability to tolerate a surgical procedure and can include total nephrectomy, partial nephrectomy or antibiotic therapy 2,5 . Surgical removal of the affected kidney results in satisfactory resolution of the fistula 1 .…”