Fistulas in malignant gynecologic disease: etiology, imaging, and management.
A fistula that occurs in association with a malignancy of the female reproductive tract may be caused by a primary or recurrent tumor or may be a complication of surgery or radiation therapy. Identification of the cause, complexity, and location of a fistula is essential for optimal management planning. Radiologic imaging, particularly with computed tomography and magnetic resonance techniques, is invaluable for the assessment of gynecologic fistulas and may help direct the clinician toward the most appropriate management pathway. The modality and technique selected for the initial imaging evaluation depend largely on the clinical history and manifestations. However, imaging with a combination of techniques often is required for accurate diagnosis and effective treatment planning. Radiologists should be familiar with suggestive clinical signs and symptoms as well as with the characteristic appearances of rectovaginal, vesicovaginal, ureterovaginal, enterovesical, enterocutaneous, and other pelvic fistulas at multimodality imaging.
Narayanan
Priya
P
Academic Department of Radiology, St Bartholomew's Hospital, Dominion House, 59 Bartholomew Close, London EC1A 7ED, England. pnaray@hotmail.com
Nobbenhuis
Marielle
M
Reynolds
Karina M
KM
Sahdev
Anju
A
Reznek
Rodney H
RH
Rockall
Andrea G
AG
D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications* / Q000175:diagnosis*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D014719:Vesicovaginal Fistula / Q000175:diagnosis* / Q000209:etiology*