Abstract

TORRADO ARENAS, Daniel Mauricio et al. Reno-appendicular fistulus as an unusual presentation of xanthogranulomatous pyelonephritis: a case report. Medicas UIS [online]. 2021, vol.34, n.3, pp.79-84.  Epub June 22, 2022. ISSN 0121-0319.  https://doi.org/10.18273/revmed.v34n3-2021008.

Uro-enteric fistula is a pathological communication between the urinary and digestive tract. Compromise of the appendix is infrequent and few cases of reno-appendicular fistulas have been described in the literature. The case of patient with symptoms of fever, low back pain and severe right hydronephrosis secondary to staghorn calculus on urinary tract tomography is presented. Initially managed with antibiotics and nephrostomy under fluoroscopy, subsequently suspended by passing contrast to the intestine. A contrasted tomography was performed which reported a fistula from the kidney to the intestine. A nephrectomy was carried out and a fistula was found to the appendix, for which a concomitant appendectomy was performed with evident clinical improvement. The pathology reported xanthogranulomatous pyelonephritis and secondary appendicitis. Reno-appendicular fistula has nonspecific symptoms, contrasted tomography is a diagnostic tool and most are detected as an intraoperative finding. Treatment is usually surgical, with nephrectomy and intestinal segment repair. MÉD.UIS.2021;34(3): 79-84.

Keywords : Apéndice; Cálculos coraliformes; Fístula urinaria; Nefrectomía; Pielonefritis xantogranulomatosa; Riñón; Appendix; Staghorn stones; Urinary fistula; Nephrectomy; Xanthogranulomatous pyelonephritis; Kidney.

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