Renocolic fistula secondary to a perinephric abscess: a late complication of a forgotten double J stent

Abstract

Late complications of ureteral stents are frequent, and longer indwelling times are associated with an increased frequency of complications. Although there are reports of various complications of long-term indwelling ureteral stents, a renocolic fistula secondary to a perinephric abscess resulting from an indwelling ureteral stent has not been reported. Here, we present a fatal case of a renocolic fistula secondary to a perinephric abscess caused by an encrusted forgotten double J stent in a functionally solitary kidney.

Keywords: Catheters, Indwelling; Complications; Urinary Fistula.

Fig. 1

Renal ultrasonography revealed moderate hydronephrosis of the right kidney with an abscess-like collection measuring 7.2×8.4 cm in the upper pole of the right kidney and right perinephric space. The proximal part of the forgotten ureteral stent was observed in the dilated renal pelvis.

Fig. 2

Computed tomography demonstrated that the right renal pelvis was connected to the ascending colon via the perinephric abscess. Contents with the same attenuation were observed in the ascending colon, right renal pelvis, and perinephric space. The nephrostomy catheter was placed in the right renal pelvis through the posterolateral aspect of the right kidney.

Fig. 3

Antegrade pyelography through the nephrostomy catheter revealed a fistula between the right pelvocalyceal system and ascending colon. The contrast clearly shows the haustra of the ascending colon.