A rare case of colonephrocutaneous fistula complicated with a brain abscess is a lifethreatening clinical condition. We report a case of a 35-year-old lady with a history
of partial left nephrectomy complicated with left colonic injury who presented with
persistent vomiting associated with headache and blurry vision for 5 days. Clinically,
she was confused and restless with Glasgow Coma Scale (GCS) of 12/15, however
her pupils were equal and reactive bilaterally. Other neurological examinations were
unremarkable. Abdominal examination noted functioning ileostomy with a skin
opening at left lumbar with pus discharge. Diagnosis of brain abscess was made after
contrasted computed tomography (CT) scan of brain. Urgent open drainage surgery
was done followed by long course of antibiotic. Contrasted CT abdomen and
fistulogram revealed a left colo-psoas and left nephrocutaneous fistula, hence, she
was subjected for surgery. Intraoperatively, there was a fistula tract connecting the
descending colon, remaining of left kidney, and the skin. Thus, left hemicolectomy,
completion of left nephrectomy, and fistulectomy was done. The long-standing
infective foci can lead to septic emboli and causes formation of abscess at distant
site. Its management is challenging involving both medical and surgical therapy
