PIP: The case is described of a 53-year old woman who had given birth three times and had undergone one abortion. After she was treated as an outpatient because of back pain in the lower waist area suppuration occurred from a fistula laterally right to the sacral bone in the area of the buttocks triangle, which persisted even after several outpatient surgical interventions. In addition, she had experienced a weight loss of 24 kg. At admission she had a temperature of 39 degrees Celsius, anemia, and leukocytosis. Sonography indicated slight hepatomegaly, hydroureter, right-sided hydronephrosis, and an right ovarian cyst of 4 cm size. Computer tomography showed a blurry structure that extended from the right kidney pole along the M. iliopsoas caudally up to the small pelvis, pressing against the organs caudally-ventrally, which also broke through dorsally between the lumbar region vertebrae and pelvis in the gluteal region percutaneously. The process was categorized as a frank paranephritis prolapsus abscess. Cessation of urine was determined. Laparotomy was carried out because of the suspicion of an inflammatory adnexal disease with parametritis. The uterus, including both adnexa as well as the conglomeration tumor, were removed. In the uterine cavity a Dana Cor IUD was found that had been inserted 13 years before and forgotten by the patient. At the site of the right adnexum there was a tumor (9 x 6 x 5 cu. cm) as well as a tube changed by inflammation (7 x 1.5 sq. cm). On the right side there was unspecific, suppurative salpingitis and in the ovary an abscess formation on the grounds of actinomycosis. On the left side there was only a suppurative inflammation of the tube without actinomycosis sediment. Immediately a high-dose antibiotic therapy (Penicillin G, 10 million IU) was started, lasting for 1 year. The kidney cessation with the back complaints rapidly disappeared. The cutaneous fistulae healed with scarring, however, a fully normal right-sided kidney function could not be restored.