Pyeloduodenocolic fistula.
A 75-year-old man presented with epigastric pain and melaena. Multiple right renal stones were seen on abdominal X-ray. Computed tomography of the abdomen and oesophagogastroduodenoscopy revealed features of a pyeloduodenal fistula. Elective surgery was planned but the patient developed torrential bleeding with shock. Emergency laparotomy revealed a necrotic right kidney with a pyeloduodenocolic fistula. This report is the first of a pyeloduodenocolic fistula caused by squamous cell carcinoma of the renal pelvis. We review the literature and discuss the aetiologies, clinical presentations, diagnosis, and treatment of pyeloduodenal fistula.
Poon
Jensen Tung-Chung
JT
Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong.
Tam
Po-Chor
PC
Chu
Kent-Man
KM
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D004378:Duodenal Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D007669:Kidney Calculi / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D007680:Kidney Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D007682:Kidney Pelvis / Q000000981:diagnostic imaging / Q000503:physiopathology; D007813:Laparotomy / Q000379:methods; D008297:Male; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D014548:Urinary Fistula / Q000150:complications / Q000175:diagnosis* / Q000601:surgery