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Case Reports: Unusual association of diseases/symptoms
Nephrocolocutaneous fistula from a staghorn calculus
  1. Cesar Karunungan Jacinto III,
  2. Michael Geoffrey Lee Lim,
  3. Marc Paul Jose Lopez and
  4. Dennis Pestano Serrano
  1. Department of Surgery, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
  1. Correspondence to Dr Cesar Karunungan Jacinto III; rocky_awp{at}yahoo.com

Abstract

Fistula formation between the kidney, colon and the skin is an extremely rare complication arising from renal infections secondary to renal stone formation. During the 1980s, reports of nephrocolic fistulas, with or without involvement of the skin, were commonly caused by genitourinary tuberculosis. Due to improvements in diagnosis and specifically the development of anti-Koch’s therapy, the incidence of nephrocolic or nephrocolocutaneous fistulas has become uncommon especially in developed countries.

We report a case of a patient residing in a developing country, presenting with a 20-year history of a left flank lesion extruding minimal purulent output daily. He was seen at the emergency department due to weakness and was managed as a case of urosepsis. Contrast-enhanced CT scan and fistulogram showed a staghorn calculus in the left kidney with connections to the descending colon and skin. The patient eventually underwent a left hemicolectomy with en bloc excision of the kidney and fistula tract.

  • Gastrointestinal system
  • Renal system
  • Urinary and genital tract disorders
  • Urinary tract infections
  • Urinary tract infections

https://doi.org/10.1136/bcr-2022-249351

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    Footnotes

    • Twitter @mgllimMD

    • Contributors CKJ and MGLL managed the patient during admission and performed the surgery on the patient. They had a direct role in the patient’s management. They are also the ones who primarily wrote the case report. MPJL and DPS are consultants of the Division of Colorectal Surgery and Urology, respectively. They took an active role in the conferences on determining the management of the patient. They have been updated throughout the patient’s course during admission and during and after surgery. They both took an active role in editing the paper multiple times until the final draft was formulated.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.