Jian Hui Wu, Department of Urology, Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin First Center Hospital, Tianjin 300211, China.
Yong Xu, Department of Urology, Second Hospital of Tianjin Medical University,Tianjin Institute of Urology, Tianjin 300211, China.
Pak J Med Sci. 2014 Mar;30(2):443-5.
Pyeloduodenal fistula is a rare condition and its association with malignancy is even rarer. Herein we report the case of a 66-year-old man who was admitted to the hospital with a three-month history of intermittent melena and a more than 20-year history of right-side renal stones. Computed tomography showed a heterogeneous right renal mass with a staghorn stone that had invaded the duodenum and caused an internal fistula. An upper gastrointestinal series showed pyeloduodenal fistula. The patient underwent an exploratory operation and a biopsy was taken at the peripelvic region. Pathological examination verified the existence of squamous cell carcinoma. To our knowledge, this is the first case of pyeloduodenal fistula associated with renal stones, squamous cell carcinoma and upper urinary tract calculus presenting on melena. We report on the features of this rare entity but also review and summarize the etiology, diagnosis and treatment options that can be extrapolated from the existing literature.
肾盂十二指肠瘘是一种罕见的疾病，其与恶性肿瘤的关联更为罕见。本文报告了一例 66 岁男性患者的病例，该患者因间歇性黑便病史 3 个月，右侧肾结石病史 20 余年而入院。计算机断层扫描显示右肾混杂性肿块伴鹿角形结石，侵犯十二指肠并导致内瘘。上消化道系列检查显示肾盂十二指肠瘘。患者接受了探查手术，并在肾盂周围区域进行了活检。病理检查证实存在鳞状细胞癌。据我们所知，这是首例肾结石、鳞状细胞癌和上尿路结石导致黑便的肾盂十二指肠瘘病例。我们报告了这种罕见实体的特征，同时也回顾和总结了可以从现有文献中推断出的病因、诊断和治疗选择。
