Renocolic Fistula Secondary to Tuberculosis: A Case Report
Although renocolic fistula is a rare pathology, it is the most common of renoalimentary
fistulas. This pathology continues to decrease in frequency in the last 50 years due to early
and better management of renal diseases.
This presentation adds a recent case of renocolic fistula secondary to TB to the already
existing literature whilst we discuss how to best diagnose and manage this affection.
A 75-year-old Moroccan man was admitted in our department
for a 2 month history of left low back pain associated with an
irritable bowel syndrome, fever and weight loss.
This patient had a medical history of hypertension and
ischemic cardiomyopathy under diuretics, β-blockers and low
dose aspirin. There was no preceding history of pulmonary tuberculosis.
Physical examinations found the patient in an altered general condition. His blood pressure and body temperature was 160/100 mmHg and 38.5 °C respectively. The patient had a left flank pain and tenderness.
here is no specific clinical sign to diagnose a renocolic fistula.
Flank pain and fever are the most frequent symptoms.
Pyuria, fecaluria, pnematuria and fever can be occasionally present.
Hence, the diagnosis of a renocolic fistula and its underlying cause is largely dependent on radiological imaging.
The most useful imaging modalities are CT urography, barium enema, colonoscopy and antegrade or retrograde pyelogram.
Each imaging modality has its advantages and disadvantages. The CT scan is by far the best imaging modality to establish the diagnosis of renocolic fistula as in our case. Generally, a couple of these imaging modalities are required to determine the presence of a fistula and its underlying cause.
Urol Androl Open J. 2017; 1(1): 18-21. doi: 10.17140/UAOJ-1-105