ABSTRACT
Objective To improve the diagnosis and tr ea tment level of reno-colic fistula. Methods The clinical data of 6 patients (4 males and 2 females,average age of 37 years) with reno-c olic fistula were analyzed retrospectively.Among them,4 cases had the fistula on the right side and 2,on the left.On etiology,3 cases had nephrolithiasis compli cated with infection;1,nephrolithiasis accompanied by carcinoma of renal pelvis; 1, tuberculosis of kidney; 1,perinephric abscess.There were no typical clinical symptoms in the 6 patients and they underwent retrograde pyelography or antegrad e pyelography for confirmation of diagnosis. Results Sur gical management was carried out in the 6 patients.Among them,1 case underwent n ephrectomy,colectomy and colocolostomy;2,nephrectomy,fistulectomy and repair of the colon;2,pyelolithotomy or ureterolithotomy,fistulectomy and repair of the ki dney and colon;1 case of nephrolithiasis with carcinoma of renal pelvis underwen t exploratory laparotomy and tumor biopsy with no surgery due to severe adhesion of the kidney and colon with the peripheral tissues.Five patients were followed up for 8 months to 9 years (mean,46 months) postoperatively;no surgical complic ation occurred and they had a satisfactory recovery.Only 1 case died of metastas is of tumor 6 months postoperatively. Conclusions Nephro lithiasis complicated with infection is a major cause of reno-colic fistula.Ret rograde pyelography or antegrade pyelography is the most reliable method in the diagnosis of reno-colic fistula.As soon as the diagnosis is made, surgical trea tment should be performed.