XGPN is a rare chronic granulomatous inflammation of the renal parenchyma that if left untreated can lead to chronic renal injury. The mainstay treatment for XGPN is simple nephrectomy with curative intent. It represents just 1% of histologically diagnosed pyelonephritis with a 2:1 predilection for females within the 5th-6th decade of life. Nearly all cases are associated with staghorn calculi and often present with complications inclusive of peri-renal abscess, psoas abscess and acute kidney injury. We present a case of a rare complication: reno-colic fistula formation in an elderly woman with XGPN confirmed on histopathology at nephrectomy. Successful simple wedge resection of large bowel was undertaken with the patient having excellent post operative outcomes.

Keywords: Reno-colic Fistula; Xanthogranulomatous pyelonephritis; XGPN