Alt ve Üst Gastrointestinal Fistüllerin Gösterilmesinde Kontrastlı Fluoroskopik Çalışmalar

Öz

Üst ve alt gastrointestinal (GI) fistüllerin saptanmasında, yerlerinin belirlenmesinde ve uzanımlarının görülmesinde konvansiyonel fluoroskopik kontrastlı çalışmaların yararlılığını araştırmayı amaçladık. Çalışmamıza, klinik olarak çeşitli tiplerde GI fistülleri olduğu düşünülen, yaşları 1 ay ile 75 yaş arasında değişen  24 hasta dahil edildi. Fistülleri göstermek için suda çözünür iyotlu kontrast ajanlar her olgu için en uygun şekilde oral, perkütan veya rektal yoldan  verildi. Olgular etiyolojik olarak sınıflandırıldı. Fistüllerin, orokutanöz/tiroglossal (n=1), trakeoözofageal (n=4), özofagoplevral (n = 4), gastrokolik (n=1), duodenorenal (n=2), duodenokütanöz (n=1) , enterokutanöz (n = 2), enterovezikal (n=1), kolokütanöz (n = 1), kolovezikal (n=1), rektovezikal (n=1), rektovajinal (n=1), anorektokütanöz (n= 4) olduğu ve uzanımları etkin olarak gösterilebildi. İatrojenik etyolojiler (cerrahi, radyoterapi vb.), 24 hastanın 11'inde (%45.8)  GI fistüllerin başlıca nedeni olarak tespit edildi. Kontrast madde geçişini gerçek zamanlı olarak görebilmemiz, seçtimiz bölgeye yönelik çalışabilmemiz, farklı projeksiyonlarda yüksek uzaysal çözünürlükte görüntüler elde edebilmemiz nedeniyle, değişik türlerde GI fistüllerin ilk görüntülemesinde konvansiyonel fluoroskopik kontrastlı çalışmaların tercih edilen radyolojik yöntem olmaya devam ettiği sonucuna vardık. 

Anahtar Kelimeler

• ince barsak,kolon,sineradyografi,fistül

The Utility of Fluoroscopic Contrast Studies in Demonstration of Upper and Lower Gastrointestinal Fistulas

Öz

Our aim was to investigate the utility of conventional fluoroscopic contrast studies in detecting, localizing the upper and lower gastrointestinal (GI) fistulas and seeing their extensions. Our study included 24 patients between 1 month to 75 years of ages who were clinically suspected to have various types of GI fistulas. We administered water soluble iodinated contrast agents orally, percutaneously and rectally  in an appropriate way in each case to demonstrate the fistulas. The cases were etiologically classified. We were able to demonstrate orocutaneous/thyroglossal (n=1), tracheoesophageal (n=4), esophagopleural (n=4), gastrocolic (n=1), duodenorenal (n=2), duodenocutaneous (n=1), enterocutaneous (n=2), enterovesical (n=1), colocutaneous (n=1), colovesical (n=1), rectovesical (n=1), rectovaginal (n=1), anorectocutaneous (n=4) fistulas and their extensions effectively. Iatrogenic etiologies (surgery, radiotherapy etc.) were found to be the leading cause of  GI fistulas by 11 patients out of 24 ( 45.8%). Since we are able to see contrast material flow real-time, make selective studies and get highest spatial resolution images in different projections, we conclude that conventional fluoroscopic contrast studies remain to be the radiologic method of choice particularly for the initial imaging of various types of GI fistulas.

Anahtar Kelimeler

• Small intestine,colon,fluoroscopi,fistula

Kaynakça

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