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Post renal transplant sinus tract (CT fistulography)

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Primary hyperoxaluria and end-stage renal disease. Persistent pus drainage through a right lower quadrant cutaneous orifice after removal of a rejected transplanted kidney.

Patient Data

Age: 35 years
Gender: Female
  • large sinus tract starts from the RLQ orifice traversing the right paracolic space with communication to the right psoas muscle
  • bilateral medullary and cortical nephrocalcinosis
  • large hyperdense stone along with right kidney mid to upper pole 
  • diffuse bony sclerosis

Case Discussion

Primary hyperoxaluria is a rare autosomal recessive inborn error of metabolism that leads to elevation of oxalate in serum and urine and characterizes by calcium oxalate crystal deposition in multiple organ systems (oxalosis).

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