The utility of fluoroscopic contrast studies in demonstration of upper and lower gastroin-testinal fistulas

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