黄色肉芽腫性腎盂腎炎による腎結腸瘻の1例

Abstract

Renocolic fistulas caused by typical xanthogranulomatous pyelonephritis are rare. We present a case of renocolic fistula caused by xanthogranulomatous pyelonephritis. A 58-year-old woman was admitted to the Department of Urology, Sakata City Hospital, with the chief complaint of pain in the left flank region. The plain film showed no calculi. An intravenous pyelogram showed left non-functioning kidney. A left retrograde pyelogram demonstrated a communication between the left renal calyx and the descending colon. A computed tomography done after the retrograde pyelography revealed contrast medium in the descending colon and a heterogenous left renal mass and thickness of Gerota's fascia. On the basis of the radiologic studies a diagnosis of renocolic fistula was made. The patient underwent a nephrectomy with closure of the fistula of the colon. The pelvicaliceal system of the resected kidney was distended and contained yellow fatty like tissue. Histologically xanthogranulomatous pyelonephritis was confirmed. The patient made an uneventful recovery.