From the Department of Nuclear Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Clin Nucl Med. 2021 Jan;46(1):66-68. doi: 10.1097/RLU.0000000000003386.
A 60-year-old woman with recurrent urinary tract infection who had several operations for colorectal carcinoma underwent Tc-DMSA renal scintigraphy which showed an unexpected accumulation of radiotracer in the colon. When symptoms were reviewed, we noticed that she was suffering from pneumaturia and fecaluria which raised the suspicion of enterovesical fistula. Rectal contrast-enhanced computer tomography of pelvis demonstrated enterovesical and enterovaginal fistulas. Colonic radioactivity was considered to be related to retrograde peristalsis of Tc-DMSA from bladder activity via enterovesical fistula. In patients with pelvic surgeries and radiotherapy, radioactivity in the colon should raise the suspicion of enterovesical fistula.
一位 60 岁的老年女性，因反复尿路感染，曾多次接受结直肠癌手术，行 Tc-DMSA 肾闪烁显像检查，结果显示放射性示踪剂在结肠内意外积聚。当对症状进行回顾时，我们注意到她患有气尿和粪尿，这引起了我们对肠膀胱瘘的怀疑。盆腔直肠增强 CT 显示肠膀胱和肠阴道瘘。考虑到放射性示踪剂是通过肠膀胱瘘从膀胱活动逆行蠕动进入结肠的，因此认为结肠的放射性与 Tc-DMSA 有关。在接受过盆腔手术和放疗的患者中，结肠的放射性应提示肠膀胱瘘的可能。
