PDF(Pubmed)
Abstract：
BACKGROUND Nephro-colic fistulas are uncommon, generally caused by local inflammation, trauma, or neoplasia affecting the kidney or the colon. Their association with a coralliform stone is described in a few case reports, but their management is difficult and differs quite a lot, depending on the clinical situation. We report an atypical clinical case of a reno-colic fistula associated with a staghorn calculus. This case adds to the literature an iconography rarely found. CASE REPORT A 68-year-old woman presented to the Emergency Department with respiratory symptoms and chronic abdominal pain. The biological results showed a high inflammatory syndrome. The radiological assessment revealed a retroperitoneal and left retro-renal abscess, attributed to a left nephro-colic fistula associated with the partial passage of a lithiasis within the colonic lumen. Colonoscopy confirmed the diagnosis. Multiple recurrences of diverticulitis in this region could be the origin of the complication. First, the patient was treated with antibiotic therapy and radiological drainage. Second, she benefited from a left nephrectomy, left segmental colectomy, and splenectomy. The clinical and radiological evolution were favorable after surgery. The follow-up was disrupted by hospitalizations in the Cardiology Department for cardiac decompensation. CONCLUSIONS Kidney stones along with local inflammatory phenomena can be the cause of a nephro-colic fistula. Due to the lack of guidelines in such cases, their diagnosis and management are difficult to ascertain. Surgery is the right course of treatment.
摘要：
背景技术肾绞痛瘘并不常见,一般由局部炎症引起,创伤,或影响肾脏或结肠的肿瘤。在一些病例报告中描述了它们与珊瑚状石头的关联，但是他们的管理很困难，而且差异很大，取决于临床情况。我们报告了与鹿角状结石相关的肾绞痛瘘的非典型临床病例。这种情况增加了文献中很少发现的图像。案例报告一名68岁的妇女因呼吸道症状和慢性腹痛出现在急诊科。生物学成果显示高度炎症综合征。放射学评估显示腹膜后和左肾后脓肿，归因于与结石病在结肠腔内部分通过相关的左肾绞痛瘘。结肠镜检查证实了诊断。该地区憩室炎的多次复发可能是并发症的起源。首先,患者接受抗生素治疗和放射引流治疗.第二,她从左肾切除术中受益，左段结肠切除术,和脾切除术.手术后临床和放射学演变良好。随访因心脏代偿失调而在心脏科住院而中断。结论肾结石和局部炎症现象可能是肾绞痛瘘的原因。由于在这种情况下缺乏指导方针，他们的诊断和管理很难确定。手术是正确的治疗方法。
