Few centres including our own have shown improved visualisation of fistulous tracts and their relationship to the surrounding perianal structures using MR fistulogram
, a procedure involving injection of diluted gadolinium into the tract using an infant feeding tube.
Visualization of blood flow, as demonstrated by a fistulogram
, was an endpoint before leaving the procedure room.
The confirmatory diagnosis, however, is made via a fistulogram
(angiography) with and without manual compression.
The diagnostic value of MRI fistulogram
and MRI distal colostogram in patients with anorectal malformations.
was done which showed a communication of the track with the gut.
3] In the absence of pneumaturia, the diagnosis is done radiologically either by barium enema, retrograde pyelogram, CT scan or fistulogram
It can be performed through percutaneous non-surgical procedures like Fistulogram
, Fistuloplasty, stenting and thrombolysis.
According to the fistulogram
, the right tract was continuous with the oropharyngeal area and the left punctum showed pooling of contrast material in the cervical area (figure 2).
Investigations are invariably non-specific, and the diagnosis is nearly always made radiologically through a barium enema, RGP, antegrade pyelography, CT scan or if there is cutaneous extension, fistulogram
or MRI which can outline the track and the level of the internal opening.
It was useful to see clearly marked and labelled pre- and post-fistulogram
images in the atlas with explanations outlining how a fistulogram
can identify a problematic access.
A CT fistulogram
showed a fistulous tract communicating with the caecum and the peritoneal cavity (Figures 1 and 2).