PMC9621025_01
Cystography, renal dynamic imaging and stool imaging.
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Therefore, to confirm the diagnosis, we performed the following verification: First, we obtained the stool of this patient, measured its urinary creatinine value after centrifugation of the stool (2504 umol/L), and obtained the urine of another patient with normal renal function to measure its urinary creatinine value (3442 umol/L); then cystography revealed that contrast agent was exuding from the bladder (see Figure 1A and B); thereafter, renal dynamic imaging was performed, and we found that over time, the contrast agent was gradually visualized in both kidneys and bladder (see Figure 1C), and the stool sample of the patient also shows this visualization (Figure 1D).
(A) Terminal ileum; (B) cecum; (C) ascending colon; (D) ascending colon; (E) transverse colon; (F) descending colon; (G) sgmoid colon; (H) rectum.
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To understand the cause of urinary fistula, a colonoscopy was conducted and showed multiple ulcers in the large intestine: Crohn's disease? (Figure 2), and colonic tissue biopsy revealed chronic inflammation and granulation tissue hyperplasia (Figure 3).
Pathological biopsy of the rectum, ascending colon, transverse colon, and cecum: chronic inflammation of the (rectal) mucosa.
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To understand the cause of urinary fistula, a colonoscopy was conducted and showed multiple ulcers in the large intestine: Crohn's disease? (Figure 2), and colonic tissue biopsy revealed chronic inflammation and granulation tissue hyperplasia (Figure 3).
(A) Ileocecal orifice; (B) cecum; (C) ascending colon; (D) ascending colon; (E) transverse colon; (F) sigmoid colon; (G) rectum; (H) anal canal.
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During this period, the patient returned to the outpatient department regularly, and enteroscopy showed ulcer healing in November 2020 (Figure 4).