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Acquired gastrointestinal fistulas: classification, etiologies, and imaging evaluation
Perry J Pickhardt1, Sanjeev Bhalla, Dennis M Balfe
1Department of Radiology, National Naval Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889-5600, USA. pjpik@hotmail.com
Radiology
|July 2, 2002
Summary
This review details acquired gastrointestinal fistulas, focusing on their elusive causes and varied symptoms. It highlights how advanced imaging, including CT and MRI, aids in diagnosing and managing these complex conditions.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Pathology
Background:
- Fistulas are abnormal connections between epithelial surfaces.
- Gastrointestinal fistulas involve the alimentary tract and can be congenital or acquired.
- Acquired gastrointestinal fistulas significantly impact patient outcomes, often presenting with diverse clinical signs and unclear origins.
Purpose of the Study:
- To provide a comprehensive review of acquired gastrointestinal fistulas.
- To emphasize the critical role of imaging in the detection and management of these fistulas.
- To present a classification scheme and discuss major causes and individual fistula types.
Main Methods:
- Review of existing literature on acquired gastrointestinal fistulas.
- Emphasis on contemporary imaging modalities, including computed tomography (CT) and magnetic resonance imaging (MRI).
- Discussion of fluoroscopic studies as a complementary diagnostic tool.
Main Results:
- Acquired gastrointestinal fistulas have protean manifestations and often elusive etiologies.
- Cross-sectional imaging (CT, MRI) has become central to radiologic evaluation.
- Fluoroscopic studies remain valuable for confirming and defining fistulous tracts.
Conclusions:
- A classification system for gastrointestinal fistulas is presented.
- Major causes and specific fistula types are discussed.
- Contemporary imaging approaches are elaborated for improved diagnosis and management.