Contents
Fistulography is one of the special diagnostic methods that is used to study fistulous pathological processes occurring in the joints or bones. With this method of research, the diagnostician can study in detail the current state of the process in the patient, as well as monitor the course and development of the disease, which will help to choose the right method of therapy and prescribe a treatment regimen.
What is fistulography
Fistulography is an X-ray examination method that allows you to identify the presence of fistulas in the articular and bone tissues. In most cases, such a diagnosis is carried out during a comprehensive examination of the skeletal system, which is necessary to identify possible pathologies.
The basis for this technique is a contrast agent, which, using x-rays, is able to give a clear picture of the disease, the presence of fistulous passages, as well as the severity and area of the lesion.
Using this diagnostic method, it is possible to identify the occurrence and development of the inflammatory process, the course of an abscess, as well as possible foreign bodies in the tissues of the body. Fistulography also determines the direction of the existing fistulous passages, which in the future allows you to more accurately and quickly determine the appropriate therapy.
The contrast agent in this diagnosis is most often an alcohol or oil solution of iodine. Before the start of the examination, the fistulous passages are thoroughly cleaned, after which the necessary amount of a contrast agent is injected into them, which, having passed along the entire length of the fistula, makes it possible to determine their length and direction. In some cases, for particularly sensitive patients or with severe pain, this diagnosis is carried out under local anesthesia.
This study is used primarily for complete information about the detected fistula, the duration of its course, the degree of development of the disease, as well as the location of its location. Fistulography is also used repeatedly with an already identified disease to correct previously prescribed therapeutic procedures.
The attending physician prescribes this study, which also determines the frequency of its use. Such diagnostics are re-assigned to those patients who have not had a positive result for a long time with the treatment methods used.
Indications for the procedure
This technique is prescribed in various cases. The presence of any fistulas is an unequivocal reason for this procedure, because fistulography allows you to fully see the picture of the disease, on the basis of which the specialist will make the appropriate treatment. Indications for such a diagnosis are:
- the presence of fistulas in the intestines and esophagus;
- the occurrence of fistulas in the biliary tract or in the bladder resulting, for example, from cholecystectomy;
- intestinal and skin fistulas;
- fistulas in the tissues of the stomach;
- fistulas resulting from inflammatory and infectious processes, as well as caused by the ingestion of a foreign body;
- vaginal fistulas;
- ear fistulas;
- pilonidal sinus.
This method of research is also shown in osteomyelitis, as it helps to detect fistulous passages in purulent-inflammatory processes in bone tissue.
With the help of such a procedure, it is much easier to determine the cause that caused the appearance of the fistulous tract, its nature, and also to choose the most appropriate method of therapy.
Contraindications for fistulography
Contraindications for this diagnostic method include:
- individual intolerance or hypersensitivity of the patient to the contrast agent;
- severe course of the disease;
- infectious and inflammatory processes in the area of the occurrence of a fistula;
- the presence of bloody discharge from the fistulous passages.
Pronounced inflammatory processes occurring in the patient’s body and negatively affecting his general condition are also a contraindication to the procedure.
This diagnostic technique is absolutely safe, however, if there are any of the contraindications, its use is undesirable, as it can lead to undesirable consequences and negative complications.
Types of procedure and course of its course
Fistulography is divided into two types, which differ in contrast agent:
- an oily or alcoholic solution of iodine acts as a contrast agent, injected directly into the fistulous passages using local anesthesia, since such an intervention can be noticeably painful;
- an oily or alcoholic solution of barium sulfate is used as a contrast agent, which can determine the stages of pathology development even with very wide fistulas.
Preparation for the procedure includes the following items:
- Cleansing the fistulous passages from the contents immediately before the diagnosis, only after that it is possible to inject a contrast agent into the fistula.
- It is recommended to pre-lubricate the fistula entrance with any oil solution in order to exclude the occurrence of possible allergic reactions.
- Before using this diagnostic method, it is desirable to conduct several x-ray examinations that allow you to see several different projections of the pathological focus.
The procedure may cause pain and discomfort at the site of the procedure. It can be reduced by using local anesthetics.
After the introduction of a contrast agent using X-rays, pictures of the organ affected by the fistula are taken in various projections, which makes it possible to accurately judge the direction of the fistulous tract and the pathological processes occurring in it.
At the end of the fistulography, the fistulous passages are cleaned of the contrast agent with a disinfectant solution.
The interpretation of the results is carried out by the attending physician on the basis of the studies and additional clinical tests prescribed.
Summing up
Fistulography is one of the types of X-ray examination, which is used to identify and diagnose various fistulous tracts. Carrying out such a procedure will help to give the most complete result about the course of the inflammatory process, the stage and severity of the disease. Also, according to its results, one can judge the direction and length of fistulous passages, which plays an important role in prescribing appropriate therapy.
The attending physician prescribes such a diagnostic method based on indications for its implementation, as well as excluding possible contraindications that can lead to negative and unnecessary consequences.