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Are Nephroenteric Fistulas Only a Surgical Trouble?
Davide Campobasso1, Pietro Granelli1, Umberto Maestroni1
1Urology OU, Surgical Department, University Hospital of Parma, Via Gramsci 14, 43123 Parma, Italy.
The Indian Journal of Surgery
|August 7, 2015
Summary
Nephroenteric fistulas, often pyelocolic, present diagnostic challenges. Surgical intervention, including nephrectomy, is typically required for these complex kidney-gastrointestinal tract connections.
Area of Science:
- Urology
- Gastroenterology
- Surgical Pathology
Background:
- Nephroenteric fistulas are uncommon connections between the kidney and gastrointestinal tract.
- Pyelocolic fistulas are the most frequent type, often stemming from kidney stones or infections.
- Delayed diagnosis is common due to nonspecific symptoms and varied presentations.
Purpose of the Study:
- To report three distinct cases of nephroenteric fistulas.
- To highlight the diagnostic and management complexities of these conditions.
- To emphasize the critical role of surgical intervention and infection control.
Main Methods:
- Case series presentation of three patients with nephroenteric fistulas.
- Review of clinical presentations, diagnostic workup, and treatment outcomes.
- Surgical management involving radical nephrectomy and intestinal resection.
Main Results:
- One case of pyelo-duodenal fistula secondary to kidney stones and pyonephrosis.
- One case of pyelocolic fistula due to chronic ureteral stones and hydropyonephrosis.
- One rare case of post-traumatic pyelocolic fistula.
Conclusions:
- Nephroenteric fistulas pose significant diagnostic and surgical challenges.
- Radical nephrectomy and intestinal resection are often necessary for definitive treatment.
- Management requires careful control of sepsis and a balanced approach to patient care.
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