Alt ve Üst Gastrointestinal Fistüllerin Gösterilmesinde Kontrastlı Fluoroskopik Çalışmalar

Yıl 2020, Cilt: 42 Sayı: 1, 34 - 38, 01.01.2020

Mehmet Ercüment Döğen Ümit Yaşar Ayaz Baki Hekimoğlu

https://doi.org/10.20515/otd.451464

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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