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  • Title: A case with fistula formation between a perinephric retroperitoneal abscess, a ureter and a descending colon: Successful outcome after conservative management.
    Author: Iwamoto Y, Kato M.
    Journal: Can Urol Assoc J; 2014 Sep; 8(9-10):E644-6. PubMed ID: 25295138.
    Abstract:
    A 72-year-old man diagnosed with hydronephrosis and perinephric abscess because of an impacted urinary stone in the left uretero-pelvic junction was admitted to hospital with high-grade fever. The insertion of a percutaneous drain improved his general condition. Then, imaging from the percutaneous drainage tube revealed a fistula formation between the cavity of the perinephric retroperitoneal abscess, the descending colon, and the left renal pelvis. The patient received conservative management, including insertion of a percutaneous drain, discontinuation of oral intake and antimicrobial chemotherapy. Three days after the percutaneous drainage and discontinuation of oral intake, imaging revealed no apparent fistula. Fistula formation between a perinephric abscess and the descending colon is very rare; this is the first case of a long-term favourable outcome by conservative management.
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