Renoalimentary Fistula Differential Diagnoses

Updated: Jan 06, 2021
  • Author: M Francesca Monn, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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DDx

Diagnostic Considerations

Identification of a renoalimentary fistula is largely based on diagnostic imaging and procedures.  Cross sectional imaging demonstrating air in the urinary tract with bowel closely approximating the renal collecting system, particularly after recent surgical interventions (such as percutaneous nephrolithotomy or radiofrequency ablation of renal tumors) or in the setting of xanthogranulomatous pyelonephritis, and without other reasons for its presence should prompt consideration of this rare fistula.

Underlying causes should be located or ruled out as renoalimentary fistulae are relatively rare. Spontaneous renoalimentary fistula that are not associated with iatrogenic causes tend to commonly be associated with primary bowel pathologies such as inflammatory bowel disease or malignancies. In the absence of a primary bowel pathology or possible iatrogenic cause, a diagnosis of renoalimentary fistula is less likely [15] .

Differential Diagnoses

  • Entero-vesical fistula

  • Pyelonephritis

  • Uretero-intestinal fistula