Nephrobronchial fistula a case report and review of the literature

Tamburrini, Stefania; Fiorini, Valeria; Lugarà, Marina; Napodano, G.; Biondo, Dario Del; Squame, Fiorenzo; Sarti, Giuseppe; Quassone, Pasquale; Coppola, Maria Gabriella; Iannuzzi, Michele; Stasio, M. Di; Shatalova, Olena; Marano, I.; Cagini, Lucio

doi:10.1016/j.radcr.2021.08.025

Cited by 10 publications

(10 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A nephrobronchial fistula results from kidney inflammation that progresses to the respiratory system, most cases being mainly reported because of pyelonephritis. 4 - 6 We report the first case of a nephrobronchial fistula with calculi in a patient with histopathological results suggesting IgG4-related disease. The pathophysiology is uncertain, and we believe that local IgG4 inflammation could lead to the development of posterior fistulas in adjacent organs such as the diaphragm and kidneys, although there are no other systemic manifestations related to the disease.…”

Section: To the Editormentioning

confidence: 89%

See 1 more Smart Citation

Nephrobronchial fistula: a diagnostic challenge in a patient with IgG4-related disease

Cabral Marinho Plens1,

das Posses Bridi1,

Caroline Toledo do Nascimento2

et al. 2023

J Bras Pneumol.

View full text Add to dashboard Cite

Section: To the Editormentioning

confidence: 89%

“… 3 Nephrobronchial fistulas are rare complications of kidney disease, occurring mainly in association with perinephric abscesses after infectious episodes. 4 We describe the case of a nephrobronchial fistula in a patient with IgG4-related disease. Free and informed consent was obtained from the patient.…”

Section: To the Editormentioning

confidence: 99%

Nephrobronchial fistula: a diagnostic challenge in a patient with IgG4-related disease

Cabral Marinho Plens1,

das Posses Bridi1,

Caroline Toledo do Nascimento2

et al. 2023

J Bras Pneumol.

View full text Add to dashboard Cite

“…Common symptoms are general malaise, dysuria, flank pain (non-colicky), hematuria, fever, chills, unintentional weight loss, and loss of appetite; symptoms have usually been present for some time, longer than 6 months in 42% of patients [ 17 , 18 ]. In some cases, patients can present only with signs and symptoms related to superimposed complications, such as shortness of breath as a result of empyema caused by intrathoracic communication or discharging sinus from the flank wall as a result of renocutaneous fistulation [ 13 , 19 , 20 ]. A delay in diagnosis can contribute to epithelium dedifferentiation and dysplasia and favor cancer development, increasing the chance of its occurrence more than twice [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

MDCT Diagnosis and Staging of Xanthogranulomatous Pyelonephritis

Tamburrini¹,

Comune

Lassandro³

et al. 2023

Diagnostics

Self Cite

View full text Add to dashboard Cite

Background: Benign nephrectomy to treat patients with renal inflammatory disease in cases of severe urinary infection represents a diagnostic and management challenge because of significant inflammatory, fibrotic, and infectious components. Among renal inflammatory diseases, fistulization and invasiveness to adjacent structures are some of the hallmarks of xanthogranulomatous pyelonephritis (XGP). The aims of this study were as follows 1. to retrospectively determine key demographic and clinical features of XGP among benign nephrectomies; 2. to assess the CT preoperative diagnostic accuracy; and 3. to define the imaging characteristics of the CT stage. Material and Methods: A retrospective review of clinical, laboratory, and radiological features and operative methods of patients who underwent benign nephrectomy with histologically proven XGP was performed. Results: XPG was diagnosed in 18 patients over a 4-year (2018–2022) period. XGP represented 43.90% among benign nephrectomies. The mean age of the patients was 63 years, and the sex prevalence was higher in women (72.22%). Symptoms were vague and not specifically referrable to urinary tract disorders and unilateral (100%), with the left kidney affected in 61.11% of cases. Staghorn calculi and stone disease were the most common underlying cause (72.22%). All patients underwent CT. The preoperative CT imaging accuracy for renal inflammatory disease was 94.44% and indeterminate in 5.56%. A suspected diagnosis of XGP was formulated in 66.67% (12/18; 2 stage II/10 stage III), meanwhile, in 33.33% (6 patients with stage I), a non-specific diagnosis of renal inflammatory disease was formulated. CT was reported according to the Malek and Elder classification and staged in the stage I nephric form (33.33%), stage II perinephric form (11.11%), stage III paranephric form (55.56%). Conclusions: The CT diagnostic accuracy for kidney inflammatory disease was extremely high, whereas the suspected diagnosis of XGP was formulated preoperatively in only 66.67% of high-stage disease, where the hallmarks of invasiveness and fistulization of the pathology increased the diagnostic confidence.

show abstract

“…It is most commonly associated with a chronic obstructive uropathy secondary to a staghorn calculus, and Proteus Mirabilis or Escherichia Coli urinary tract infection [1] , [2] . Parenchymal destruction can be so severe that it can lead to fistula formation and invasion into surrounding structures, with nephrobronchial fistulation being a very rare consequence of XGP [3] . Standard management is with targeted antimicrobials, abscess drainage and surgical intervention with nephrectomy and fistula repair in severe cases [3] .…”

Section: Introductionmentioning

confidence: 99%

“…Parenchymal destruction can be so severe that it can lead to fistula formation and invasion into surrounding structures, with nephrobronchial fistulation being a very rare consequence of XGP [3] . Standard management is with targeted antimicrobials, abscess drainage and surgical intervention with nephrectomy and fistula repair in severe cases [3] . This case highlights the significant complications which can follow untreated urinary tract infection and nephrolithiasis, and demonstrates that XGP should be considered in all patients with chronic or complicated pyelonephritis.…”

Section: Introductionmentioning

confidence: 99%