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Updated: Jan 27, 2026

Photoacoustic Cystography
Published on: June 11, 2013
Value of direct radionuclide cystography in diagnosing vesico-peritoneal fistulae
Piotr Szumowski1, Saeid Abdelrazek2, Małgorzata Mojsak2
1Department of Nuclear Medicine, Medical University of Bialystok, ul. Marii Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland. piotrmjs@wp.pl.
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.
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