Reno-appendiceal fistula in autosomal dominant polycystic kidney disease

Area of Science:

• Nephrology
• Surgical Urology
• Gastroenterology

Background:

• Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by numerous cysts in the kidneys.
• Reno-appendiceal fistulas are exceedingly rare, with few documented cases in medical literature.
• Surgical management of ADPKD often involves nephrectomy for complications.

Observation:

• A 53-year-old female with known ADPKD was undergoing open bilateral nephrectomy.
• An incidental finding revealed a fistula connecting the mid-appendix to a cyst in the lower pole of the right kidney.
• The fistula's likely etiology was attributed to chronic inflammation.

Findings:

• The patient was diagnosed with a rare reno-appendiceal fistula.
• An appendectomy was performed concurrently with the planned right nephrectomy.
• Complete excision of the fistulous tract was achieved.

Implications:

• This case highlights the importance of recognizing rare anatomical anomalies in patients with complex kidney diseases.
• It underscores the need for comprehensive surgical planning when managing ADPKD complications.
• The successful surgical intervention demonstrates effective management of this unusual fistula.