Guided tour of hidden tracts in the pelvis: exploring pelvic fistulas

Abstract

Background Fistulas are an abnormal connection between two or more epithelial surfaces. When fistulization between adjacent structures occurs in the pelvis, there is almost invariably significant associated morbidity and impact on a patient’s quality of life. Imaging may aid in the diagnosis of pelvic fistulas and is essential to identify any associated pathology, define the course of the fistula, and aid in pre-surgical planning. Purpose This article aims to review the wide array of clinical and imaging presentations of fistulas in the pelvis, with a focus on the radiologists’ role in managing this challenging entity. Methods This article will review each classification type of fistula. Results Pelvic fistula is a devastating condition that causes significant morbidity and evaluation can be challenging. Conclusions Imaging, and particularly MRI, plays a vital role in the diagnosis, characterizing the course of a fistula and demonstrating associated complications, which are essential to guide treatment decisions.

MRI Case Report of Perianal Fistula with T2 TSE SPIR Sequence

“…In another study, CT scan fistulography was able to locate the internal orifice in 28 patients (68.2%), whereas MRI was able to detect this aspect in 35 patients (85.3%).was more successful (Shahzad et al, 2021). Granulation tissue, inflammation, and edema around the fistula, abscess, and fistula wall fibrosis were also evaluated, from the study benefit from resonance imaging Magnetic (MR) includes Multiplanar imaging and advanced soft tissue differentiation (Madany et al, 2023;Sharma et al, 2022) MRI is a diagnostic imaging tool that is very crucial in Pelvis MRI in cases of perianal fistula (Chen et al, 2021;Hyde et al, 2018;Lee et al, 2018). Examination technique and Pelvis MRI sequence for perianal fistulas used in routine examinations at MRI Radiology Installation Mayapada Hospital South Jakarta using a marker procedure at a location suspected of having a perianal fistula using vitamin E with the clockwise method and the sequence used T1W_TSE, T2W_TSE, and T2W_TSE_SPIR followed by gadolinium-based contrast material sequence T1W_TSE (Konan et al, 2018;Kakani, 2021;Sarma, 2019;Westbrook & Talbot, 2019).…”