A Case of Pyeloduodenal Fistula Successfully Treated without Nephrectomy

Pyeloduodenal istula is a rare condition and due to its rarity its management has not been well established. We present here a case of a 69-year-old male patient with a long history of lower urinary tract malignacy as well as urinary stones who was admitted to the hospital due to progressive gastrointestinal and constitutional symptoms. Computed tomography showed an Urinoma outgoing from the right renal pelvis with a suspected istula to the duodenum. The diagnosis of a pyeloduodenal istula was con irmed endoscopically with an esophagogastroduodenoscopy. From our point of view surgery was necessary. The patient underwent an exploratory operation, where the istua was excised. Moreover, we performed a primary closure of the renal pelvis and the duodenum. The postoperative course was uneventful. He was discharged from the hospital after an antegrade pyelogram revealed no evidence of leakage or istula formation. In addition we report on the features of this rare entity and also review and summarize the etiology, diagnosis and treatment options that can be extrapolated from the existing literature.