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Perinephric Abscess with Fistula Formation to Descending Colon: A Case Report and a Review of the Literature

Thomas J S Durant, Jaclyn Olsen, Vishal Bhuva, Jonathan Mogen, Jason Jacob
Connecticut Medicine 2015, 79 (4): 221-4

UNLABELLED: A perinephric abscess (PA) is an uncommon clinical entity. We present a case of a patient with aknown chronic perinephric hematoma, complicated by infection, subsequently developing a fistula to the adjacent descending colon. To the knowledge of these authors, there are no reported cases of perinephric abscess fistula formation with the descending colon.

CASE REPORT: A 50-year old woman with multiple medical comorbidities presented with gram negative sepsis and was subsequently found to have a cyst on her left kidney. Following CT-guided biopsy, an iatrogenic hematoma was formed and subsequently became infected. Radiographic evaluation revealed fistula formation between the abscess and the adjacent descending colon. Conservative management resulted in closure of the fistula without the need for further surgical management.

DISCUSSION/CONCLUSION: Perinephric abscess (PA) formation can result in significant morbidity and mortalitywith complications including sepsis, renal failure and fistula formation. We present a first case report in which a PA fistualized with the descending colon following percutaneous drainage.

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