A 75-year-old man presented with epigastric pain and melaena. Multiple right renal stones were seen on abdominal X-ray. Computed tomography of the abdomen and oesophagogastroduodenoscopy revealed features of a pyeloduodenal fistula. Elective surgery was planned but the patient developed torrential bleeding with shock. Emergency laparotomy revealed a necrotic right kidney with a pyeloduodenocolic fistula. This report is the first of a pyeloduodenocolic fistula caused by squamous cell carcinoma of the renal pelvis. We review the literature and discuss the aetiologies, clinical presentations, diagnosis, and treatment of pyeloduodenal fistula.
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