[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.
Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada. emargim@gobiernodecanarias.org
E
E
Martínez Gimeno
C
C
Ramos Font
A
A
Allende Riera
C
C
Cárdenas Negro
M
M
de Sequera Rahola
M D
MD
Albalá González
A
A
Rodríguez Fernández
J A
JA
Uña Gorospe
L
L
Antón Hernández
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