SPONTANEOUS NEPHROCOLIC FISTULA

SUMMARY1 One new case of nephrocolic fistula has been reported and represents the now commonest calculous, non–tuberculous, pyonephrotic type. 2 The four astiological factors responsible are presented. 3 The clinical presentation may be confusing, particularly after antibiotic administration, and radiological evidence in the form of a retrograde pyelogram or chromatological evidence using indigo–carmine provides the best diagnostic criteria. 4 The fistula is usually small and after separation closure is a simple matter. 5 The previously quoted mortality rate of 30 per cent, for this condition is undoubtedly much lower today because of earlier diagnosis and the advent of chemotherapy.I am indebted to Mr W. H. Graham, F.R.C.S., for permission to publish this case.