Map of the fistula tract
It is important for the surgeon to know the entire architecture of the fistula: whether the course ends blindly, whether it is connected to the intestine, bladder, bone or residual cavity (abscess), whether there are side pockets - incomplete excision leads to relapse. Contrast fills all communicating spaces, and photographs in two projections give a three-dimensional impression; for complex fistulas, the study is complemented by CT fistulography. Performed for ligature fistulas after surgery, pararectal (beyond exacerbation), osteomyelitic and other chronic fistulas.
Indications
- acute abdominal pain - exclusion of obstruction and perforation (survey image);
- dysphagia, stomach pain, suspicion of an ulcer and tumor—scopy/barium graph;
- injuries and pain in the pelvic area - photographs of the pelvic bones;
- fistulas after operations and inflammation - fistulography;
- control of the chest organs in motion (diaphragm, mediastinum).
Copy and graphics
X-ray is a picture that records the condition of an organ; fluoroscopy - real-time observation showing motility: peristalsis of the stomach and intestines, mobility of the diaphragm, the passage of barium through the esophagus and pylorus. Therefore, for functional tasks (impaired swallowing, gastric evacuation, suspected dynamic obstruction), a copy is used, and to document the morphology (ulcer niche, filling defect in a tumor, mucosal relief) a series of targeted images is used; often methods are combined in one study.
