Tubercular renocolic fistula: an unusual presentation

The development of a fistula between colon and kidney is very rare. An unusual case of renocolic fistula is reported in a middle-aged obese lady who presented with septicemia, acute respiratory distress syndrome and acute renal shut-down with underlying uncontrolled diabetes mellitus. The patient was stabilized after intensive care management and the diagnosis of left renocolic fistula with left renal stone was established on contrast-enhanced computed tomography of the abdomen and barium enema. She underwent left nephrectomy with left hemicolectomy and colocolic anastomosis. Surprisingly, the final diagnosis on histopathology turned out to be renocolic fistula with underlying tuberculosis. The aim of this rare case report is to create awareness of atypical presentation of renocolic fistula so that timely diagnosis and intervention can salvage such patients.