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Title

Asymptomatic Urolithiasis Complicated by Nephrocutaneous Fistula

Authors
Amzalag, Gaël
Published in Journal of Clinical Imaging Science. 2017, vol. 7, p. 9
Abstract Asymptomatic spontaneous nephrocutaneous fistula is a rare and severe complication of chronic urolithiasis. We report a case of 56-year-old woman with a nephrocutaneous fistula (NFC) which developed from a superinfected urinoma following calyceal rupture due to an obstructing calculus in the left ureter. The patient was clinically asymptomatic and came to the emergency department for a painless left flank fluctuating mass. This urinoma was superinfected, with a delayed development of renal abscesses and perirenal phlegmon found on contrast-enhanced uro-computed tomography (CT), responsible for left renal vein thrombophlebitis and left psoas abscess. Thereafter, a 99 mTc dimercaptosuccinic acid (DMSA) scintigraphy revealed a nonfunctional left kidney, leading to the decision of left nephrectomy. Chronic urolithiasis complications are rare and only few cases are reported in medical literature. A systematic medical approach helped selecting the best imaging modality to help diagnosis and treatment. Indeed, uro-CT scan and renal scintigraphy with 99 mTc-DMSA are the most sensitive imaging modalities to investigate morphological and functional urinary tract consequences of NFC, secondary to chronic urolithiasis.
Identifiers
PMID: 28299237
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Article (Published version) (1.3 MB) - public document Free access
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Research group Radiologie des urgences (800)
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HAMARD, Marion et al. Asymptomatic Urolithiasis Complicated by Nephrocutaneous Fistula. In: Journal of Clinical Imaging Science, 2017, vol. 7, p. 9. https://archive-ouverte.unige.ch/unige:107095

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Deposited on : 2018-08-16

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