PMC6498772_01
Upper endoscopy with blood clot in the stomach.
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Bedside esophagogastroduodenoscopy (EGD) revealed a large amount of clotted blood in the stomach, unamenable to lavage (Figure 1).
Computed tomography scan of abdomen and pelvis with intravenous contrast
showing left renal calculus and reno-gastric fistula.
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A computed tomography (CT) scan of the abdomen and pelvis with intravenous contrast showed a left renal staghorn calculus, a peripancreatic and perirenal fluid collection suspicious for abscesses, and possible presence of fistulous tracts connecting the perirenal fluid collection to the gastric wall and the descending colon (Figure 2).
Barium enema showing contrast extravasation from the splenic flexure.
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A barium enema demonstrated a fistula at the level of splenic flexure with contrast extravasation into the left upper quadrant of the abdomen (Figure 3).