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Value of direct radionuclide cystography in diagnosing vesico-peritoneal fistulae
Affiliations- Department of Nuclear Medicine, Medical University of Bialystok, ul. Marii Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
- Department of Urology, J. Sniadecki Provincial Hospital of Bialystok, ul. M. Curie-Skłodowskiej 26, 15-950 Białystok, Poland
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Abstract
A 36-year-old female patient underwent a laparoscopic surgery to remove a uterine fibroid. The procedure failed to relieve the pelvic pain, although its nature changed. After a period of observation, the patient was re-admitted to hospital on suspicion of a vesico-uterine fistula to be differentiated with endometriosis. Diagnostic investigations — cystography, cystoscopy, computed tomography and magnetic resonance — did not reveal a fistula. Laparoscopy was performed, with a possible biopsy in order to eliminate endometriosis. The result was negative, but chronic progressive reactive/inflammatory lesions were noticed, possibly indicating the presence of a vesico-peritoneal fistula. Therefore, a direct radionuclide cystography was performed. The scintigraphic images single-photon emission computed tomography (SPECT/CT) showed a radioactive spot, indicative of a vesico-peritoneal fistula. The fistula was treated for three months by catheterisation of the urinary bladder. The follow-up SPECT-CT did not reveal any urine leakage from the bladder. The clinical symptoms disappeared as well.
Abstract
A 36-year-old female patient underwent a laparoscopic surgery to remove a uterine fibroid. The procedure failed to relieve the pelvic pain, although its nature changed. After a period of observation, the patient was re-admitted to hospital on suspicion of a vesico-uterine fistula to be differentiated with endometriosis. Diagnostic investigations — cystography, cystoscopy, computed tomography and magnetic resonance — did not reveal a fistula. Laparoscopy was performed, with a possible biopsy in order to eliminate endometriosis. The result was negative, but chronic progressive reactive/inflammatory lesions were noticed, possibly indicating the presence of a vesico-peritoneal fistula. Therefore, a direct radionuclide cystography was performed. The scintigraphic images single-photon emission computed tomography (SPECT/CT) showed a radioactive spot, indicative of a vesico-peritoneal fistula. The fistula was treated for three months by catheterisation of the urinary bladder. The follow-up SPECT-CT did not reveal any urine leakage from the bladder. The clinical symptoms disappeared as well.
Keywords
radionuclide cystography, single-photon emission computed tomography, vesico-peritoneal fistule
About this articleTitle
Value of direct radionuclide cystography in diagnosing vesico-peritoneal fistulae
Journal
Issue
Article type
Clinical vignette
Pages
105-106
Published online
2017-05-25
Page views
950
Article views/downloads
1049
DOI
Pubmed
Bibliographic record
Nucl. Med. Rev 2017;20(2):105-106.
Keywords
radionuclide cystography
single-photon emission computed tomography
vesico-peritoneal fistule
Authors
Piotr Szumowski
Saeid Abdelrazek
Małgorzata Mojsak
Robert Kozłowski
Monika Sykała
Dorota Jurgilewicz
Janusz Myśliwiec
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