Fistulas and sinus tracts: radiographic evaluation, management, and outcome

A retrospective review of 50 sinus tracts and 87 fistulas is presented. The etiologies, methods of radiographic evaluation including computed tomography and ultrasound, means of radiographic intervention, and disposition of sinus tracts and fistulas are discussed. Despite the newer imaging modalities, a sinogram or a fistulogram is still the best means of evaluating a sinus tract or fistula when an external communication is present. Computed tomography is helpful if exact spatial delineation of the tract is necessary or an associated abscess is suspected. Ultrasound examination is generally not useful, being limited by bowel gas and surgical incisions.