Pyelo-Hepatic Fistula Resulting From a Perinephric Abscess: A Case Report and Literature Review

The extension of a renal infection to the liver is extremely rare. We present the case of a 70-year-old woman with right hip pain and delayed detection of a perinephric abscess involving her liver. Tomographic and endoscopic contrast studies revealed the presence of a fistulous tract between her liver and right kidney. With minimally invasive intervention, including placement of a ureteral stent, two hepatic drains, a nephrostomy tube, and culture-directed antimicrobial therapy, her infection resolved. Closure of the fistula was subsequently confirmed radiographically. This is the first reported incidence of a pyelo-hepatic fistula resulting from a perinephric abscess.