Fistulas and sinus tracts: Radiographic evaluation, management, and outcome

Abstract

A retrospective review of 50 sinus tracts and 87 fistulas is presented. The etiologies, methods of radiographic evaluation including computed tomography and ultrasound, means of radiographic intervention, and disposition of sinus tracts and fistulas are discussed. Despite the newer imaging modalities, a sinogram or a fistulogram is still the best means of evaluating a sinus tract or fistula when an external communication is present. Computed tomography is helpful if exact spatial delineation of the tract is necessary or an associated abscess is suspected. Ultrasound examination is generally not useful, being limited by bowel gas and surgical incisions.

Use of preoperative computed tomography for surgical treatment of recurrent draining tracts

“…In fact, accurate preoperative localisation of the FB (when possible) and diseased tissues are essential for a rational surgical decisionmaking approach. Several imaging modalities have been used to preoperatively localise FB and/or RDTs, including plain radiography, sinography, ultrasonography, magnetic resonance imaging (MRI) and CT (Alexander et al 1982, Brennan & Ihrke 1983, McEvoy et al 1993, Fayolle et al 1998, Frendin et al 1999, Matteucci et al 1999, Merlo & Lamb 2000, Yamagishi et al 2000, Penninck & Mitchell 2003, Staudte et al 2004, Young et al 2004, Gnudi et al 2005, Johnsson et al 2006, Jones & Ober 2007, Kligman et al 2007, Dobromylskyj et al 2008, Nicholson et al 2008, Schultz & Zwingenberger 2008, Cherbinsky et al 2010). Yet, to the best of the authors' knowledge, no study in the veterinary literature has proposed and evaluated a rational decision-making approach based on the use of preoperative imaging for surgical planning in animals with RDTs in the thoracic and abdominal regions.…”

“…Several imaging modalities have been used to preoperatively localise FB and/or RDTs, including plain radiography, sinography, ultrasonography, magnetic resonance imaging (MRI) and CT (Alexander et al . , Brennan & Ihrke , McEvoy et al . , Fayolle et al .…”

Radiographic and Endoscopic Diagnosis and Treatment of Enterocutaneous Fistulas

“…Fistulograms are the most rapid and direct method of linking a cutaneous opening with the gastrointestinal (GI) tract. 7,14 In the absence of sepsis, fistulograms may be the only imaging study needed. 15 The technique of a fistulogram is simple.…”

Non-traumatic abdominal emergencies: imaging and intervention in acute pancreatic conditions

“…16a-c). At this level -pancreatico-mediastinal fistula -when the pancreatic enzymes are activated, mediastinitis can set in with fatal results [50,51]. Pseudocyst or erosion of the esophagus or the pericardium is also possible [52].…”