22.3.17

An elderly man (65 years old) presented with a sinus on the back in the loin area, occasionally discharging when the patient passed urine. Investigations revealed a poorly functioning non-salvageable left kidney, and the MRI scan reported xanthogranulomatous pyelonephritis with a nicely outlined fistula through the posterior abdominal wall onto the skin of the back on the left side. A difficult nephrectomy was performed along with excision of the whole fistula tract.