Pyeloduodenal fistula complicating xanthogranulomatous pyelonephritis

Diffuse xanthogranulomatous pyelonephritis with complex spontaneous pyeloduodenal fistula: A case report

“… 11 Nephrectomy is the recommended treatment for XGP with the healing rate of 80% 6 despite encouraging outcome of conservative management has been sporadically reported. 1 In the present case, total nephrectomy was the treatment of choice owing to a non-functioning kidney along with a complex fistula.…”

“…Xanthogranulomatous pyelonephritis (XGP) is a rare and severe form of chronic pyelonephritis characterized by destruction of the renal parenchyma and replacement by foamy, lipid-laden macrophages. 1 , 2 Although XGP is usually confined to the affected kidney, it occasionally extends to adjacent tissues, resulting in further complications such as perirenal abscess, adhesion to pancreas, or various forms of fistula. 1 , 3 , 4 Spontaneous pyeloduodenal fistula is an extremely rare complication of XGP.…”

“… 1 , 2 Although XGP is usually confined to the affected kidney, it occasionally extends to adjacent tissues, resulting in further complications such as perirenal abscess, adhesion to pancreas, or various forms of fistula. 1 , 3 , 4 Spontaneous pyeloduodenal fistula is an extremely rare complication of XGP. We present a case of diffuse XGP complicated by a complex pyeloduodenal and ureteromuscular fistulae with cutaneous opening.…”

“…To our knowledge, there are only several case reports which describe such a complex fistula in XGP in the English literature. 1,2 The patient underwent total nephrectomy combined with fistula closure and recovered uneventfully.…”

Pyeloduodenal Fistula in Xanthogranulomatous Pyelonephritis

“…XGP is challenging to diagnose and PDFs are exceedingly rare. Only a handful of cases have been reported [1][2][3]. This case was remarkable for the rapid progression from staghorn renal calculus to fistulizing XGP over a matter of months.…”