A Case of Enterocutaneous Fistula Diagnosed with Tc-99m DTPA Fistulography Using Hybrid SPECT/CT

Enterocutaneous fistula (ECF) is a communication between the bowel lumen and the skin, which especially occurs post-operatively and is associated with significant morbidity and mortality. Correct diagnosis and anatomical information of ECF are crucial for a patient’s management. Here, we present a case of ECF clearly diagnosed by hybrid single-photon emission computed tomography/computed tomography (SPECT/CT). A 61-year-old man was admitted to our hospital with persistent pus discharge from a surgical wound of previous cystectomy and ileal conduit formation. Initially, he was assessed with fistulography, and ECF was suspected by intraluminal contrast media. As clinical symptom and signs were not definitely matched with ECF, Tc-99m diethylene triamine pentaacetic acid (DTPA) SPECT/CT was performed for the evaluation of fistular tract as an alternative method. On the SPECT/CT after injection of Tc-99m DTPA to the putative fistular opening, fistular as well as intraluminal radioactivity was clearly visualized. SPECT/CT is a sensitive and safe diagnostic imaging tool for ECF.