eng Science and Education Publishing Global Journal of Surgery 2379-8750 2019-11-05 7 1 26 30 10.12691/js-7-1-5 JS2019715 article Arvind Navaneethkumar 1 WM Mokhzani Wmokhzani@gmail.com 2 Department of Surgery, Hospital Raja Permaisuri Bainun, Ipoh, Perak Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu, Kelantan We present a case of a 50-year-old lady left gluteal collection with communication into the left retroperitoneal plane and continuous with left xanthogranulomatous pyelonephritis. She underwent wound debridement and left nephrectomy. It was subsequently complicated with delayed colonic perforation, recurrent episodes of colocutaneous and nephro-colic fistula. We discuss the complications associated with xanthogranulomatous pyelonephritis and the challenges in managing it. http://pubs.sciepub.com/js/7/1/5/js-7-1-5.pdf Xanthogranulomatous pyelonephritis Nephro-colic Fistula Nephrectomy inflammation psoas abscess