PMC3056206_01
Computed tomography after abdominal trauma reveals left renal injury (grade IV, black arrow) and perirenal hematoma (white arrow).
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On the radiologic examination in the previous hospital, there was only left renal injury (grade IV/V) and perirenal hematoma with no evidence of renocolic fistula (Figure 1) and mild hemothorax. 
Cystoscopy demonstrates air bubbles jetting at the left ureteral orifice (arrow).
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On the cystoscopy, we found a diffuse mucosal edema suggesting cystitis and an air bubble jetting in the left ureteral orifice, but fecal materials were not seen in the bladder and around the left ureteral orifice (Figure 2).
Antegrade pyelogram shows the fistula from the left renal pelvis into the proximal descending colon. Contrast media is flowing backward into the descending colon (arrow).
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On the antegrade pyelography through percutaneous nephrostomy, the left ureter showed a normal feature but there was contrast congestion in the splenic flexure of the colon (Figure 3).
CT of the abdomen and pelvis. There is a gas shadow in the left renal pelvis (black arrows).
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Computed tomography (CT) of abdomen and pelvis revealed multiple gas shadows in the left renal pelvis and the bladder associated with a fistula tract between the lower area of the left pelvis and the splenic flexure of the colon with inflammatory changes (Figure 4) The right kidney showed normal contrast enhancement without any abnormality. 