Williams Kristen, Owen Mackenzie, Honeycutt Andrea
Internal Medicine, University of North Carolina School of Medicine, Chapel Hill, USA.
Internal Medicine, WakeMed Raleigh Hospital, Raleigh, USA.
Cureus. 2025 Sep 16;17(9):e92456. doi: 10.7759/cureus.92456. eCollection 2025 Sep.
Colovesical fistula (CVF) is an abnormal connection between the urinary system and the bowel. It is a known complication of acute diverticulitis. Common symptoms include pneumaturia, fecaluria, and abdominal pain, amongst others. In this case, we report a rare case of acute renal failure due to a relatively asymptomatic colovesical fistula causing left-sided emphysematous pyelonephritis complicated by renal abscess. After appropriate surgical treatment and antibiotic therapy, the CVF, pyelonephritis, and abscess resolved. Unfortunately, renal function did not return to baseline, likely due to injury and poor functioning of the left kidney. Urology is considering radical nephrectomy to prevent recurrent of future infection. This case highlights a previously unknown and severe patient presentation of CVF and signifies the importance of maintaining a high index of suspicion of a fistula when a patient presents with recurrent urinary tract infections, acute renal failure, and colon pathology.
结肠膀胱瘘（CVF）是泌尿系统与肠道之间的异常连接。它是急性憩室炎的一种已知并发症。常见症状包括气尿、粪尿和腹痛等。在此病例中，我们报告了一例罕见的急性肾衰竭病例，病因是相对无症状的结肠膀胱瘘导致左侧气肿性肾盂肾炎并伴有肾脓肿。经过适当的手术治疗和抗生素治疗后，结肠膀胱瘘、肾盂肾炎和脓肿均已痊愈。不幸的是，肾功能未能恢复到基线水平，可能是由于左肾受损且功能不佳。泌尿外科正在考虑进行根治性肾切除术以预防未来感染复发。该病例突出了结肠膀胱瘘一种此前未知且严重的患者表现，并表明当患者出现复发性尿路感染、急性肾衰竭和结肠病变时，高度怀疑存在瘘管的重要性。
