Volume 8, Issue 5, October 2020, Page: 163-165
“Bubbles in My Urine” – A Presentation After Blunt Trauma
Maheshwaran Sivarajah, St.Barnabas Hospital, Bronx, New York, USA
Jonathan Gates, Hartford Hospital, Hartford, Connecticut, USA
Received: Jul. 19, 2020;       Accepted: Aug. 24, 2020;       Published: Sep. 3, 2020
DOI: 10.11648/j.js.20200805.14      View  33      Downloads  18
Fistulae forming between the alimentary tract and kidney after trauma are an anomaly. In contrast to general vesico-alimentary communication, a colonephric fistula almost invariably results secondary to an initial pathological process in the kidney. A primary infectious cause has by far been the most common renal pathology implicated in its formation. The diagnosis of this condition is suggested by pneumaturia but almost entirely based on radiological examination. Even though conservative strategies have been attempted, surgical resection is the treatment of choice and should be pursued if all else fails. We report a case of a subacute presentation of a colonephric fistula following blunt trauma with a documented injury to the kidney associated with a possible concomitant injury to the large bowel. However, the inciting event could also have been a primary occult colon injury overlying the renal injury, eventually culminating in a fistula between the two organs resulting in pneumaturia and signs of sepsis. A review of the literature on colonephric fistulae and their appropriate management strategies are reported and briefly discussed. It is important to be familiar with its clinical symptoms so that the diagnosis can be suspected, and adequate investigative and therapeutic approaches can be implemented.
Colonephric, Renocolic, Fistula, Pneumaturia, Blunt Trauma
To cite this article
Maheshwaran Sivarajah, Jonathan Gates, “Bubbles in My Urine” – A Presentation After Blunt Trauma, Journal of Surgery. Vol. 8, No. 5, 2020, pp. 163-165. doi: 10.11648/j.js.20200805.14
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Patil SB, Patil GS, Kundaragi VS, Biradar AN. A case of xanthogranulomatous pyelonephritis with spontaneous renocolic fistula. Turkish J Urol 2013; 39 (2): 122-125.
Yu NC, Raman SS, Patel M, Barbaric Z. Fistulas of the genitourinary tract: a radiologic review. RadioGraphics 2004; 24: 1331-1352.
Hippocrates: Opera Omnia: De internis affectionibus. Frankfurti: In folio, 1621, p 540; Aphorism, sec. VII, aph. X-35: 295.
Bissada NK, Cole AT, Fried FA. Reno-alimentary fistula: an unusual urological problem. J Urol 1973; 110: 273-276.
Mander BJ, Menzies D, Motson RW. Renocolic fistula. J Royal Soc Medicine 1993, Vol 86: 601-602.
Manzanila-Garcia HA, Sanchez-Alvarado JP, Rosas-Nava JE, Soto-Abraham V. Renocolic fistula secondary to colon adenocarcinoma. Rev Mex Urol 2010; 70 (3): 174-178.
Herbert FB, Goodacre B, Neal DE Jr. Successful conservative management of nephrocolic fistula. J Endourology 2001 vol 15, 3: 281-283.
Karamchandani MC, Riether R, Sheets J, Stasik J, Rosen L, Khubchandani I. Nephrocolic fistula. Dis Colon Rectum 1986; 29: 747-749.
Appel R, Musmanno M, Knight JG. Nephrocolic fistula complicating percutaneous nephrostolithotomy. Journal of Urol 1988; 140: 1007-1008.
Weizer AZ, Raj GV, O’Connell M, et al. Complications after percutaneous radiofrequency ablation of renal tumors. Urology 2005; 66: 1176-1180.
Lee SD, Kim TN, Ha HK. Delayed presentation of renocolic fistula at 4 months after blunt abdominal trauma. Case Reports in Med 2011, Article ID 103497.
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