A rare case of abscessed left renal cyst complicated by colonic fistula

Abstract

Background: nephrocolic, renocolic, or colorenal fistulas are a rare condition, generally associated with inflammatory processes of infectious, traumatic, or neoplastic origin involving the kidney. Their clinical presentation is often nonspecific, and diagnosis is primarily based on complementary imaging studies. Although various triggering factors for this pathology have been identified, no previous cases caused by an abscessed renal cyst following a low-height fall have been reported.

Case report: an 81-year-old female patient with a history of hypertension, diabetes mellitus under treatment, and a previously diagnosed simple renal cyst in the left kidney presented with fatigue and anorexia following a low-height fall. She was referred to our institution from a local hospital, where tomography revealed findings consistent with emphysematous pyelonephritis and a complex renal cyst in the left kidney, prompting the decision for surgical intervention. During surgery, a fistula between the abscessed renal cyst and the colon was identified and treated with fistulectomy and primary suture repair of the splenic flexure of the colon, along with drainage of the left renal cyst abscess. The procedure yielded favorable results and a positive prognosis. The causes of nephrocolic fistulas are often linked to inflammatory kidney processes complicated by urinary tract infections. In this case, the association between a pre-existing renal cyst and trauma from the fall should be considered. The treatment for this condition involves surgical closure of the fistulous tract. In conclusion, renocolic fistulas are generally caused by inflammatory, infectious, or traumatic renal processes. Their clinical presentation is highly variable, and management requires surgical intervention, including fistulous tract resection.