Imaging and Management of Leaks and Fistulas

Abstract

Leaks and fistulas can involve multiple organ systems, including the genitourinary, biliary, and gastrointestinal systems. Etiologies include infectious, inflammatory, traumatic injury, postoperative, and iatrogenic injury. Early identification and correct diagnosis are imperative in the appropriate management of these conditions. An array of imaging modalities is available for diagnosing leaks and fistulas, including fluoroscopy, ultrasound, computed tomography, magnetic resonance imaging, and nuclear scintigraphy. Management is a multidisciplinary approach with close communication between the interventional radiologist, surgeon, and medical subspecialist.Objectives: Upon completion of this article, the reader should be able to (1) summarize the available imaging modalities for diagnosis of leaks and fistulas, and (2) understand a basic approach to imaging-guided management of leaks and fistulas. Accreditation: Tufts University School of Medicine (TUSM) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. TUSM takes responsibility for the content, quality, and scientific integrity of this CME activity. Credit: TUSM designates this educational activity for a maximum of 1 Category 1 credit toward the AMA Physicians Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.