Xanthogranulomatous pyelonephritis is a rare and severe form of chronic pyelonephritis. Spontaneous pyeloduodenal fistula is an extremely rare complication of xanthogranulomatous pyelonephritis. We present a rare case of xanthogranulomatous pyelonephritis complicated by a complex pyeloduodenal and ureteromuscular fistulae with a cutaneous opening. https://www.bekindtopets.com/quick-find-ICON-39290-Adjustable-Track-Bar-Kit-1999-2004-F250-F350-flash-buy/