Iatrogenic Reno-Colo-Cutaneous Fistula in a case of Horse-shoe Kidney

Reno-colo cutaneous fistula is a rare entity, commonly resulting from a chronic infective or inflammatory etiology. Newer antibiotics and microbial therapies have led to their decline. However, minimally invasive surgery and percutaneous nephrostomy tube placement has resulted in their increase. We report a case of a 44 years female who underwent a percutaneous nephrolithotomy, resulting in a reno-colo-cutaneous fistula as a complication. Our case was unusual as the patient had an underlying congenital anomaly i. e. a horse-shoe kidney. Intravenous urogram showed leakage of contrast into the left colon. Computerized tomography (CT) done, demonstrated the fistulous connection and extravasation of contrast into the peri-renal space communicating with the skin surface along the tract of the nephrostomy tube. A final diagnosis of a reno-colo-cutaneous fistula was made secondary to percutaneous placement of the nephrostomy catheter. The patient was operated with resection of the fistula with an uneventful postoperative recovery. Imaging plays a pivotal role in diagnosing such anomalies and anatomical variants. It not only helps in deciding the line of treatment but also helps our fellow surgeons to provide utmost care and safe treatment with less post procedural complication