[Utility of diuretic renography in the detection of an enteroureteral fistula].
After a 2-year-old male with left impairment underwent surgery for a left vesicoureteral stenosis, his renal function was followed up by means of dynamic renal scintigraphy with 99mTc-DTPA. Incidental radiotracer accumulation was observed in left hemiabdomen tracing the descending and sigmoid colon. A vesico-colonic fistula was suspected. However, ultrasonography and cystography studies showed no presence of a vesico-enteric fistula. Because the patient persisted without symptoms, an expectant approach was adopted. One year later, he began to suffer watery diarrhoea episodes. 99mTc-DTPA renography was again performed to re-evaluated renal function and explore presence of urinary-enteric fistula. Diuretic renography demonstrated the presence of a vesical leak to sigmoid gut, which was confirmed by recovery of fecal matter from the patient. Both isotopic renograms evidenced the presence of uretero-sigmoid fistula, an uncommon postsurgical that was not detected by cystography, ultrasonography or RMN. The patient subsequently underwent surgery for fistula repair.
Martínez Gimeno
E
E
Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada. emargim@gobiernodecanarias.org
Ramos Font
C
C
Allende Riera
A
A
Cárdenas Negro
C
C
de Sequera Rahola
M
M
Albalá González
M D
MD
Rodríguez Fernández
A
A
Uña Gorospe
J A
JA
Antón Hernández
L
L
D002675:Child, Preschool; D004232:Diuretics; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging / Q000209:etiology; D005188:False Negative Reactions; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D024162:Second-Look Surgery; D012810:Sigmoid Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D016284:Technetium Tc 99m Pentetate; D014515:Ureteral Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D014517:Ureteral Obstruction / Q000151:congenital / Q000601:surgery; D014548:Urinary Fistula / Q000000981:diagnostic imaging* / Q000601:surgery
D004232:Diuretics; D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate