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Pyelo-Hepatic Fistula Resulting From a Perinephric Abscess: A Case Report and Literature Review
Jonathan Alcantar1, Emily Hahn1, Anthony Castelvecchi1
1Division of Urology, Department of Surgery John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois, USA, cookcountyhhs.org.
Case Reports in Urology
|May 22, 2026
Summary
A rare pyelo-hepatic fistula, extending a kidney infection to the liver, was successfully treated. This case highlights minimally invasive interventions for complex renal and hepatic abscesses.
Area of Science:
- Nephrology
- Hepatology
- Infectious Diseases
Background:
- Extension of renal infections to the liver is exceptionally rare.
- Perinephric abscesses can rarely involve adjacent organs, including the liver.
Purpose of the Study:
- To report the first documented case of a pyelo-hepatic fistula originating from a perinephric abscess.
- To describe the successful management of this rare condition.
Main Methods:
- A 70-year-old female patient presented with symptoms suggestive of a complex infection.
- Diagnostic imaging, including tomographic and endoscopic contrast studies, identified a fistulous tract between the liver and kidney.
- Treatment involved minimally invasive procedures: ureteral stent, hepatic drains, nephrostomy tube, and targeted antimicrobial therapy.
Main Results:
- A rare pyelo-hepatic fistula was identified in a patient with a perinephric abscess extending to the liver.
- The patient's infection resolved following a combination of minimally invasive interventions and antimicrobial treatment.
- Radiographic confirmation showed successful closure of the fistula.
Conclusions:
- This case represents the first reported instance of a pyelo-hepatic fistula secondary to a perinephric abscess.
- Minimally invasive techniques combined with appropriate antimicrobial therapy are effective in managing such rare and complex infections.
- Early detection and intervention are crucial for favorable outcomes in patients with extensive renal and hepatic infections.
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