J Korean Med Sci.  2009 Oct;24(5):960-962. 10.3346/jkms.2009.24.5.960.

Renocolic Fistula Secondary to a Perinephric Abscess: A Late Complication of a Forgotten Double J Stent

• Lee SW
• Kim JH

• KMID: 1782023
• DOI: http://doi.org/10.3346/jkms.2009.24.5.960

Abstract

Late complications of ureteral stents are frequent, and longer indwelling times are associated with an increased frequency of complications. Although there are reports of various complications of long-term indwelling ureteral stents, a renocolic fistula secondary to a perinephric abscess resulting from an indwelling ureteral stent has not been reported. Here, we present a fatal case of a renocolic fistula secondary to a perinephric abscess caused by an encrusted forgotten double J stent in a functionally solitary kidney.

Keyword

Complications; Catheters, Indwelling; Urinary Fistula

MeSH Terms

Abscess/*complications
Aged
Colonic Diseases/diagnosis/*etiology
Female
Foreign-Body Migration/complications
Humans
Intestinal Fistula/diagnosis/*etiology
Kidney/ultrasonography
Kidney Diseases/complications/diagnosis/*etiology
Kidney Failure/etiology
Sepsis/etiology
Stents/*adverse effects
Tomography, X-Ray Computed
Ureteral Obstruction/diagnosis
Urinary Fistula/diagnosis/*etiology

Figure

• 

  Fig. 1 Renal ultrasonography revealed moderate hydronephrosis of the right kidney with an abscess-like collection measuring 7.2×8.4 cm in the upper pole of the right kidney and right perinephric space. The proximal part of the forgotten ureteral stent was observed in the dilated renal pelvis.

• 

  Fig. 2 Computed tomography demonstrated that the right renal pelvis was connected to the ascending colon via the perinephric abscess. Contents with the same attenuation were observed in the ascending colon, right renal pelvis, and perinephric space. The nephrostomy catheter was placed in the right renal pelvis through the posterolateral aspect of the right kidney.

• 

  Fig. 3 Antegrade pyelography through the nephrostomy catheter revealed a fistula between the right pelvocalyceal system and ascending colon. The contrast clearly shows the haustra of the ascending colon.

Reference

1. Richter S, Ringel A, Shalev M, Nissenkorn I. The indwelling ureteric stent: a 'friendly' procedure with unfriendly high morbidity. BJU Int. 2000. 85:408–411.

2. Paick SH, Park HK, Oh SJ, Kim HH, Kim SW. Characteristics of bacterial colonization and urinary tract infection after double-J ureteral stent indwelling. Korean J Urol. 2002. 43:291–295.

3. Damiano R, Oliva A, Esposito C, De Sio M, Autorino R, D'Armiento M. Early and late complications of double pigtail ureteral stent. Urol Int. 2002. 69:136–140.

4. Singh V, Srinivastava A, Kapoor R, Kumar A. Can the complicated forgotten indwelling ureteric stents be lethal? Int Urol Nephrol. 2005. 37:541–546.

5. Chung SY, Stein RJ, Landsittel D, Davies BJ, Cuellar DC, Hrebinko RL, Tarin T, Averch TD. 15-year experience with the management of extrinsic ureteral obstruction with indwelling ureteral stents. J Urol. 2004. 172:592–595.

6. Lynch MF, Ghani KR, Frost I, Anson KM. Preventing the forgotten ureteral stent: implementation of a web-based stent registry with automatic recall application. Urology. 2007. 70:423–426.