PNEUMOURETER / PNEUMONEPHROSIS

Pneumoureter

Abstract

Pneumonephrosis is extremely uncommon. Mostly it is due to a fistula between the high urinary tract and stomach, duodenum / urinary bladder and rectum accompanied by vesico ureteral reflux with ascent of air into the ureter and the kidney. One study of 92 cases having fistula between the urinary tract and bowel reveals 60% colonic, 23% duodenal, 7% gastric, 5% enteric, 2% appendiceal and 1% rectal 1,2. In developed countries, renal fistulas are most commonly caused by iatrogenic trauma, as a complication of interventional radiographic procedures, percutaneous nephrostomy or nephrolithotomy tract replacement, extracorporeal shock wave lithotripsy and abdominal surgery. Chronic pyogenic infection and tuberculosis are now less common causes in the age of advanced antibiotics 3. Patients with necrotic renal neoplasm are at increased risk 4. Other causes include post dilatation of sigmoid colon stricture and congenital anomalies 5. Urolithiaisis in obstructive uropathy and uro sepsis are other common causes of ureterocolic fistula .