The role of an indium leukocyte scan in the diagnosis of a pyeloduodenal fistula associated with spontaneous disappearance of a staghorn calculus.

The use of a 111indium oxine-leukocyte scan (white cell scan) to establish the diagnosis of a pyeloduodenal fistula is described. The patient had a fistula that was associated with spontaneous disappearance of a large staghorn calculus in the involved kidney. The disappearance of the calculus and the presence of a pyeloduodenal fistula were confirmed at surgical exploration. Although neither an excretory urogram nor a retrograde pyelogram was useful to diagnose the fistula preoperatively a 111indium oxine-leukocyte scan revealed the renal abscess and pyeloduodenal fistula.