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.roneverhart.com/Gretsch-G5210T-P90-Electromatic-Jet-Two-90-Single-Cut-Electric-Guitar-w-Bigsby-Mako-p23063/