Spanggaard K, Hvid N K, Diatchikhine M, Olesen T H, Lund L
Department of Urology, Odense University Hospital, Odense, Denmark.
Department of Radiology, Odense University Hospital, Odense, Denmark.
Int Urol Nephrol. 2025 May;57(5):1357-1363. doi: 10.1007/s11255-024-04327-8. Epub 2024 Dec 17.
Pyeloduodenal fistula (PDF) is a communication between the renal pelvis and the duodenum. It is often secondary to other diseases. It is a rare condition and therefore infrequently described in the literature. The aim is to present a review of the current literature on PDF and to give an update of its aetiology, symptoms, investigations and treatments.
Pubmed, Cochrane Library and Embase were used to search for existing literature in English and Scandinavian languages with available abstracts in the period Jan 2000-Dec 2023.
No meta-analysis or reviews were found. In total, 24 original articles were found, including 25 cases all in all of both traumatic and spontaneous pyeloduodenal fistulas. Only four cases (15%) represented traumatic pyeloduodenal fistulas, and all of the spontaneous cases involved the right kidney and occurred due to calculi and pyonephrosis in 81% and 76% of the cases, respectively. Fever and flank pain were reported in 67% and 57% of the cases, respectively. Diagnosis was done by a CT urography or antegrade pyelography in 80% of the cases. More than 50% of all cases were managed by nephrectomy. Total parenteral nutrition (TPN) was administered alongside the nephrectomy in 28% of all cases.
A pyeloduodenal fistula often involves the right kidney and often occurs as a result of chronic renal inflammatory disease. The fistulas are most efficiently diagnosed with a CT scanning with contrast or retrograde pyelography. The most frequently used management of pyeloduodenal fistula is nephrectomy after closure of the duodenum with somatostatin and TPN.
肾盂十二指肠瘘（PDF）是肾盂与十二指肠之间的一种连通。它常继发于其他疾病。这是一种罕见病症，因此文献中对此描述较少。目的是对当前关于PDF的文献进行综述，并更新其病因、症状、检查及治疗方法。
使用PubMed、Cochrane图书馆和Embase检索2000年1月至2023年12月期间以英文和斯堪的纳维亚语言发表且有可用摘要的现有文献。
未找到荟萃分析或综述。总共找到24篇原创文章，共计25例创伤性和自发性肾盂十二指肠瘘病例。仅4例（15%）为创伤性肾盂十二指肠瘘，所有自发性病例均累及右肾，分别有81%和76%的病例是由结石和肾积脓引起。分别有67%和57%的病例报告有发热和胁腹疼痛。80%的病例通过CT尿路造影或顺行肾盂造影进行诊断。超过50%的病例采用肾切除术治疗。28%的病例在肾切除的同时给予全胃肠外营养（TPN）。
肾盂十二指肠瘘常累及右肾，且常因慢性肾脏炎症性疾病所致。通过增强CT扫描或逆行肾盂造影能最有效地诊断此类瘘管。肾盂十二指肠瘘最常用的治疗方法是在使用生长抑素封闭十二指肠并给予TPN后进行肾切除术。
