Blatstein L M, Ginsberg P C
Division of Urology, Department of Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA.
J Am Osteopath Assoc. 1996 Jan;96(1):57-9. doi: 10.7556/jaoa.1996.96.1.57.
A patient with abdominal discomfort, weight loss, and general weakness was discovered by way of ultrasound and computed tomography to have a tumor in the lower pole of the left kidney. At a second computed tomography examination, the mass had shrunken and air-fluid levels and contrast medium from previous examinations were evident, confirming a renocolic fistula. The patient underwent en bloc left radical nephrectomy with resection of the descending colon. Renal cell carcinoma was confirmed histologically. The patient has been free of disease for 4 years. Such fistulas are usually related to renal calculi or tuberculosis but, of late, more have been the result of iatrogenic trauma sustained during percutaneous renal procedures and lithotripsy. Use of computed tomography and other imaging methods should enable early detection of most renocolic fistulas, which usually are a late manifestation of advanced renal disease.
一名出现腹部不适、体重减轻和全身乏力的患者，经超声和计算机断层扫描发现左肾下极有一个肿瘤。在第二次计算机断层扫描检查时，肿块已缩小，先前检查中的气液平面和造影剂清晰可见，证实存在肾结肠瘘。患者接受了左肾根治性整块切除术并切除降结肠。组织学检查确诊为肾细胞癌。该患者已无病生存4年。此类瘘通常与肾结石或结核病有关，但近来更多是经皮肾手术和碎石术中遭受医源性创伤的结果。使用计算机断层扫描和其他成像方法应能早期发现大多数肾结肠瘘，而肾结肠瘘通常是晚期肾病的表现。
