oa Reno-cutaneous fistula as a rare complication of xanthogranulomatous pyelonephritis diagnosed by computed tomography and radionuclide scan

A discharging reno-cutaneous fistula was the first manifestation of xanthogranulomatous pyelonephritis in a 33 year old man. Because of the rarity of this complication of xanthogranulomatous pyelonephritis (less than 20 cases worldwide have been reported in the literature) its clinical and diagnostic aspects are discussed. The correct Preoperative diagnosis was made by computed tomography, gallium scintigraphy, ultrasonography and was confirmed by surgery and anatomopathologic examinations. The authors stress the technique of sinography with fractional administration of contrast medium while the patient was kept in a prone position for several minutes prior to the CT examination. This facilitated the demonstration of the entire fistulous track and enabled the establishment of a more precise diagnosis.