Pressure Augmented Colostogram

Beyond the neonatal period, in those who have undergone a diverting colostomy, the anatomy of the terminal colon and fistula can be accurately depicted fluoroscopically by performing a pressure-augmented colostogram. This method was first described by Cr-emin et al. [10] in 1972 and has subsequently been studied by Lernau et al. [21] and others [14, 46, 49], showing that it is a safe technique that can successfully demonstrate the presence or absence of a fistula in all published cases. The investigation involves the injection of water-soluble contrast medium into the distal limb of the colostomy using a balloon catheter. The balloon is inflated and traction applied to the catheter to occlude the stoma. Water-soluble contrast medium is then injected under constant gentle pres-

Imperforate Anus Colostogram

Fig. 9.4 Pressure-augmented colostogram. The initial fluoroscopic image (A) demonstrates the nipple arising from the terminal colon. Following further injection of contrast medium (B), a rectoprostatic urethral fistula is demonstrated. A second catheter has been placed in the urethra to help demonstrate the bladder and urethra proximal to the fistula

Fig. 9.4 Pressure-augmented colostogram. The initial fluoroscopic image (A) demonstrates the nipple arising from the terminal colon. Following further injection of contrast medium (B), a rectoprostatic urethral fistula is demonstrated. A second catheter has been placed in the urethra to help demonstrate the bladder and urethra proximal to the fistula

Fig. 9.5 A Micturating cystourethrogram demonstrating a rectoprostatic urethral fistula. B Retrograde urethrogram performed following a micturating cystourethrogram on withdrawal of the urinary catheter, demonstrating a rectoprostatic urethral fistula sure until a fistula is filled, and visualized with the aid of fluoroscopy. The presence of a fistula is initially indicated by the appearance of a nipple of contrast arising from the terminal colon (Fig 9.4).

Was this article helpful?

0 0
Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

Get My Free Ebook


Post a comment