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World J Gastrointest Pathophysiol. Aug 15, 2010; 1(3): 106-108
Published online Aug 15, 2010. doi: 10.4291/wjgp.v1.i3.106
Published online Aug 15, 2010. doi: 10.4291/wjgp.v1.i3.106
Colo-renal fistula: An unusual cause of hematochezia
John D Wysocki, Virendra Joshi, Naveed Gil, Tulane University School of Medicine, LA 70112 , United States
John W Eiser, Lake Erie College of Osteopathic Medicine, Erie, PA 16509, United States
Author contributions: Wysocki J drafted the paper; Joshi V reviewed, edited and approved the final paper; Eiser J collected radiology images, drafted radiology captions, and reviewed the paper; and Gil N provided histology images and captions.
Correspondence to: John D Wysocki, MD, Tulane University School of Medicine, 1430 Tulane Ave, LA 70112, United States. jwysocki@tulane.edu
Telephone: +1-814-6174294223
Received: April 8, 2010
Revised: June 3, 2010
Accepted: June 10, 2010
Published online: August 15, 2010
Revised: June 3, 2010
Accepted: June 10, 2010
Published online: August 15, 2010
Abstract
A 76 year old woman with bloody stools and symptomatic anemia presented to the Emergency Department approximately 2 wk after computed tomography (CT)-guided cryoablation to a 4.5 cm renal cell carcinoma on her left posterior kidney. The patient was initially prepped for a colonoscopy to view possible causes of lower gastrointestinal bleeding. However, the patient had a CT with PO contrast that revealed a variation of a renoalimentary fistula. The patient was subsequently brought to the operating room, and it was discovered that a colo-renal fistula had formed, with transmural perforation of the posterior descending colon. A left nephrectomy, left colectomy with colostomy and Hartmann’s pouch was performed.