RESUMEN
The diagnosis of a cholecystocolic fistula has often presented a dilemma to the practicing physician. Routine imaging modalities to confirm this diagnosis have not proven extremely successful. The presence of a small fistulous tract from the gallbladder to the colon is often difficult to demonstrate radiographically. However, with the advent of the newer hepatobiliary radioisotopic scanning agents, the ability to visualize the intrahepatic and extrahepatic bile ducts as well as the presence of the intestinal activity of the radiotracers has improved considerably. The authors present a case of cholecystocolic fistula that was adequately demonstrated with a Tc-99m-PIPIDA hepatobiliary scan. This article is the first to report demonstration of this type of fistula with hepatobiliary scanning.
Asunto(s)
Fístula Biliar/diagnóstico por imagen , Enfermedades del Colon/diagnóstico por imagen , Enfermedades de la Vesícula Biliar/diagnóstico por imagen , Fístula Intestinal/diagnóstico por imagen , Compuestos de Organotecnecio , Anciano , Femenino , Humanos , Iminoácidos , Cintigrafía , Azufre , Tecnecio , Azufre Coloidal Tecnecio Tc 99mRESUMEN
The clinical records and imaging studies of 140 patients who had 57Co-bleomycin scans were reviewed. In 53% of the patients with known tumor at the time of examination, all clinically demonstrable lesions picked up cobalt. The success rate was particularly high in carcinoma of the lung (15 of 17) and gastrointestinal tract (12 of 17). The major role of cobalt bleomycin seems to be as an early screening test for metastases in patients with carcinoma of the lung, gastrointestinal tract, and uterus. The scan is most useful in demonstrating spread to the brain, liver, and adrenals.