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Open Access Case report

Successful conservative management of a colorenal fistula complicating percutaneous cryoablation of renal tumors: a case report

Amir IS Morgan*, Andrew Doble and R Justin Davies

Author Affiliations

Cambridge Colorectal Unit and Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK

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Journal of Medical Case Reports 2012, 6:365  doi:10.1186/1752-1947-6-365

Published: 26 October 2012

Abstract

Introduction

Colorenal fistula is a rare phenomenon and may complicate percutaneous cryoablation of renal cell carcinoma. Treatment remains controversial.

Case presentation

A 62-year-old Caucasian man presented with pneumaturia and left flank pain six weeks following ultrasound-guided percutaneous cryoablation of two recurrent lesions in the left kidney 14 years after partial left nephrectomy for a left renal cell carcinoma. A computed tomography scan eight weeks after cryoablation revealed a cryoablated mass with adjacent stranding and adherent descending colon as well as bubbles of gas in the area of stranding, the left collecting system, and the bladder. These features were consistent with a colorenal fistula at the site of previous ablation. Successful resolution of the fistula, both clinical and radiological, was achieved following a complete conservative non-interventional out-patient approach. No ureteric stent or surgical intervention was employed.

Conclusions

In the absence of severe symptoms or sepsis, complete conservative management of a colorenal fistula complicating percutaneous cryoablation of renal tumors should be considered prior to interventional stenting or resectional surgery.

Keywords:
Colorenal fistula; Cryoablation; Renal cell carcinoma