PTU - Polskie Towarzystwo Urologiczne
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CODE: 3.1 - Abscess in the gluteal region - first symptom of staghorn renal calculi
Article published in Urologia Polska 2006/59/Suplement 1.


Grzegorz Piotrowicz, Rafał Jedynak, Leszek Bortnowski, Tomasz Syryło, Henryk Zieliński
Klinika Urologii CSK MON, Wojskowy Instytut Medyczny


Introduction. Purulent complications of renal stones are not common and most frequently are found in patients with diabetes, neoplasms and other diseases associated with immunodeficiency. Spontaneous nephrocutaneous fistula is an extremely rare result of these complications.
Objectives. A case of a female patient in whom the first symptom of staghorn renal calculi was an abscess within gluteal region, followed by spontaneous nephrocutaneous fistula.
Materials and methods. 76-years old woman was seen at the surgery department for an abscess of the left gluteal region. In general anesthesia the abscess draining towards sacral bone was achieved. Early recovery was uneventful. One month after the procedure patient was seen at the hospital for discharge from the wound. Fistulography was performed and drainage of the contrast agent to the collecting system as well as staghorn calculi were revealed. Intravenous pyelography and renal scintigraphy revealed no left kidney function. Patient was qualified for surgical treatment and left nephrectomy was performed. Recovery was uneventful.
Conclusions. Spontaneous nephrocutaneous fistula is a rare phenomenon. Fistulas of not an alimentary tract origin need extended urological diagnostics.