Nephrobronchial fistula complicating neglected nephrolithiasis and xanthogranulomatous pyelonephritis.

Nephrobronchial fistula is a rare complication seen in association with renal infections,trauma or stone disease. Xanthogranulomatous pyelonephritis (XGP) is an infectious disease with a potential for fistulization to lung,skin,colon and other organs. We present a case of nephrolithiasis complicated by obstruction leading to pyonephrosis and nephrobronchial fistula,treated successfully by nephrectomy and excision of fistulous tracts. Nephrobronchial fistula,although a rare complication of longstanding renal stone,should be considered when a patient presents with perirenal suppurative process. This clinical case illustrates the natural history of nephro-bronchial fistula and the relevance of early treatment of nephrolithiasis.