open access

Vol 20, No 2 (2017)
Clinical vignette
Published online: 2017-05-25
Submitted: 2017-03-19
Accepted: 2017-03-24
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Value of direct radionuclide cystography in diagnosing vesico-peritoneal fistulae

Piotr Szumowski, Saeid Abdelrazek, Małgorzata Mojsak, Robert Kozłowski, Monika Sykała, Dorota Jurgilewicz, Janusz Myśliwiec
DOI: 10.5603/NMR.2017.0018
·
Pubmed: 30900239
·
Nucl. Med. Rev 2017;20(2):105-106.

open access

Vol 20, No 2 (2017)
Clinical vignette
Published online: 2017-05-25
Submitted: 2017-03-19
Accepted: 2017-03-24

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.

Get Citation

Keywords

radionuclide cystography, single-photon emission computed tomography, vesico-peritoneal fistule

About this article
Title

Value of direct radionuclide cystography in diagnosing vesico-peritoneal fistulae

Journal

Nuclear Medicine Review

Issue

Vol 20, No 2 (2017)

Pages

105-106

Published online

2017-05-25

DOI

10.5603/NMR.2017.0018

Pubmed

30900239

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

References (4)
  1. Fettich J, Colarinha P, Fischer S, et al. Guidelines for direct radionuclide cystography in children. Eur J Nucl Med Mol Imaging. 2003; 30(5): B39–B44.
  2. Yu NC, Raman SS, Patel M, et al. Fistulas of the genitourinary tract: a radiologic review. Radiographics. 2004; 24(5): 1331–1352.
  3. Tang YZ, Booth TC, Swallow D, et al. Imaging features of colovesical fistulae on MRI. Br J Radiol. 2012; 85(1018): 1371–1375.
  4. Andersson M, Johansson L, Minarik D, et al. Effective dose to adult patients from 338 radiopharmaceuticals estimated using ICRP biokinetic data, ICRP/ICRU computational reference phantoms and ICRP 2007 tissue weighting factors. EJNMMI Phys. 2014; 1(1): 9.

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