Puthenveetil Rajeev Thekumpadam, Baishya Debajit, Barua Sasanka, Sarma Debanga
Department of Urology, Gauhati Medical College Hospital, Guwahati, Assam, India.
Asian J Urol. 2016 Jan;3(1):56-58. doi: 10.1016/j.ajur.2015.10.005. Epub 2015 Nov 7.
A rare case of nephrococutaneous fistula due to spontaneous expulsion of renal calculi is described. A 45-year-old man presented with urinary leakage from an ulcer over the left lumbar region for the last 3 months after a history of spontaneous expulsion of stones from this area. Ultrasonography abdomen revealed a small contracted kidney with multiple calculi in the kidney and renal pelvis, sinus tract from the lower pole of the left kidney with a ruptured calyceal calculus in the sinus tract. CT urography revealed a non excreting left kidney with multiple renal calculi, with hyperdense collection in the renal parenchyma extending to the subcutaneous tissue and left lung suggesting a xenthogranulomatous pyelonephritis (XGP). We performed a left-sided simple nephrectomy with excision of the fistulous tract. Histopathological examination revealed XGP. There have been a few case reports of XGP forming nephrocutaneous fistula in the back.
本文描述了一例因肾结石自然排出导致肾皮肤瘘的罕见病例。一名45岁男性，在该区域有结石自然排出史后，过去3个月来左腰区溃疡处出现尿液渗漏。腹部超声显示左肾体积缩小，肾内和肾盂有多个结石，左肾下极有窦道，窦道内有破裂的肾盏结石。CT尿路造影显示左肾无排泄功能，有多个肾结石，肾实质内高密度影延伸至皮下组织和左肺，提示为黄色肉芽肿性肾盂肾炎（XGP）。我们进行了左侧单纯肾切除术并切除瘘管。组织病理学检查显示为XGP。此前已有少数关于XGP在背部形成肾皮肤瘘的病例报告。
