What is the most common imaging method used to investigate fistulas?

The most common imaging method used to investigate fistulas is the fistulogram. A fistulogram involves the injection of a contrast material into the fistulous tract, followed by imaging, typically using X-ray or fluoroscopy, to visualize the anatomy of the fistula. This technique allows for detailed imaging of the fistula pathway, including its source, length, and any associated complications such as abscesses or other lesions.

Fistulograms are particularly valuable because they provide real-time imaging of the tract, enabling the clinician to effectively assess the function and relationship of the fistula to surrounding structures. This can guide surgical planning for repair or management of the fistula.

While other imaging modalities, such as CT scans and ultrasounds, can also be used in the assessment of fistulas, they may not provide the same level of detail regarding the anatomy of the fistulous tract itself as a fistulogram. CT scans might be used when there is suspicion of complex disease or the presence of abscesses, while ultrasound can help discern fluid collections associated with fistulas. However, neither of these methods is as specifically tailored for visualizing the fistulous pathways as a fistulogram. X-ray imaging alone does not adequately show the complexity of the