Ischemic colitis secondary to xanthogranulomatous pyelonephritis

Abstract

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.

Analysis of 35 cases of Xanthogranulomatous pyelonephritis

“…XGP may be a life‐threatening condition and generally the best management is radical surgery, as conservative measures with antibiotics fail to treat the underlying pathological process. In its most severe form, XGP can involve the surrounding structures, such as liver, duodenum and colon as well as great vessels …”

Effect of Kidney Volume on the Results of Nephrectomy Performed for Xanthogranulomatous Pyelonephritis

“…Therefore, organ and vascular injuries, long operative durations, need for intensive care due to complications, and the development of sepsis due to infection must be considered likely, and we think that the patients must be approached with a multidisciplinary plan (urology, general surgery, cardiovascular surgery, anesthesia, and infectious diseases) prior to the operation. Organ injuries, such as colon and liver injuries, have been reported in the literature as case presentations [12-13]. One of the most serious complications encountered in our clinical series was a need for splenectomy during left nephrectomy performed for XGP because the upper pole of the kidney was severely fibrotic and attached to the surrounding tissues.…”

Xanthogranulomatous Pyelonephritis: A Rare Presentation

“…Calculi may be seen in 75-86% of the patients, but our patient did not have any renal calculus (4). Culture shows Proteus and E. coli infection in 30-40% of cases (5). Additional predisposing factors include ureteropelvic junction syndrome, bladder tumor, and chronic interstitial nephritis.…”

“…Segmental XGP is characterized by segmental involvement, focal disease is mainly cortical, while diffuse XGP largely involves the renal parenchyma (3). XGP is an uncommon entity, accounting for about 0.6% of histologically documented cases of chronic pyelonephritis (4,5).…”