Computer tomography of uro-lymphatic fistulas associated with renal colic

Abstract

This article presents two clinical observations of uro-lymphatic fistulas diagnosed by computed tomography. In both cases, the patients were admitted with symptoms of renal colic. Uro-lymphatic fistulas are a rare condition caused by the formation of a connection between the urinary and lymphatic systems, which is caused by, as a rule, lymphatic vessel obstruction due to parasitic infestation. Other causes may be radiation therapy, retroperitoneal trauma, and tumor sprouting. In the era before antibiotics, infectious processes such as xanthogranulomatous pyelonephritis and renal tuberculosis were common. Cases of uro-lymphatic fistulas formed against urolithiasis background are presented below. In the clinical cases presented, urine directly entered the lymphatic vessels through a uro-lymphatic fistula detected on contrast-enhanced computed tomography. Uro-lymphatic fistulas caused by impaired urine outflow due to blocked urinary tract are rarely detected since abdominal ultrasound is the diagnostic method of choice in renal colic. In the vast majority of cases, uro-lymphatic fistulas are treated conservatively and do not require surgical intervention. As a rule, the formed fistulas cease to exist when its root cause is successfully treated.