Renal jejunal fistula with worm infestation: A rare case report from a pediatric patient

This case report details a rare instance of a renal jejunal fistula accompanied by tuberculosis (TB) and parasitic infestation in a pediatric patient. It adds to the limited literature on renal fistulas involving the jejunum, particularly those compounded by infectious diseases, highlighting the diagnostic and therapeutic challenges in managing such complex cases.

The patient initially presented with flank pain, a discharging sinus in the left flank region, cough, and general malaise, alongside symptoms of anemia. Clinical examination and diagnostics unveiled a non-functioning left kidney with multiple calculi and signs of severe pyelonephritis. However, surgery revealed an unexpected twist-a renal jejunal fistula with worm infestation.

The main diagnoses included a renal jejunal fistula, tuberculosis, and parasitic infestation. The patient underwent a left nephrectomy to remove the affected kidney, and the fistula was repaired. Postoperative care involved TB treatment and deworming. The case underscored the necessity of a comprehensive diagnostic approach and readiness for unexpected intraoperative findings.

This case highlights the importance of considering infectious diseases in the differential diagnosis of unusual renal or gastrointestinal symptoms, especially in pediatric patients from endemic regions. It demonstrates the necessity of interdisciplinary collaboration in managing rare and complex medical conditions and stresses the need for follow-up to assess long-term outcomes, which was limited in this case due to the patient's non-attendance at scheduled visits.