Learning objectives
Define an iatrogenic fistula.
Demonstrate in a case based format a variety of cases with iatrogenic fistulas in different regions of the body.
Illustrate in a multimodality approach their imaging findings from straightforward to challenging cases.
Highlight the crucial role of imaging in diagnosis of iatrogenic fistulas.
Background
What is Iatrogenic fistula?
An iatrogenic condition or disease is one which is inadvertently induced as a result of a medical treatment or procedure.
A fistula is an abnormal tract or communication between two organs in the body (two hollow structures with epithelialized surfaces) or between an organ and the exterior of the body.
So,
the presence of fistula in a background of medical intervention or treatment should raise the possibility of iatrogenic etiology.
In this Educational poster:
We present a selection of cases that...
Findings and procedure details
Iatrogenic renal arteriovenous fistula (AVFs):
Iatrogenic causes e.g.
kidney biopsy,
blunt or penetrating trauma,
inflammation,
etc.
constitute about 70 % of renal AVFs etiologies 1.
Could be a cause of persistent hematuria,
uncontrolled hypertension and/or sudden or progressive decline in the renal function 2.
Serious sequelae include high-output heart failure and distal thromboembolization are reported as well 2.
Digital subtraction angiography is the gold standard for diagnosis of renal AVF; however,
it is invasive 1,3.
Non-invasive modalities include US and CT angiography.
Ultrasound: Renal AVFs...
Conclusion
Iatrogenic fistulas are a well-known complication of various medical interventions.
They can result in increased morbidity,
prolong hospital stays and worsen overall outcomes.
Awareness of the causes of different iatrogenic fistulas,
their clinical presentation,
and familiarity with their appearances in different imaging modalities will enable radiologists to recognize and accurately diagnose them,
and thus guide appropriate management.
Personal information
Dr.
Mohammed Ali Saleh Sabawi
Diagnostic Radiology Resident,
Clinical Imaging Department,
Hamad Medical Corporation.
Doha,
Qatar.
Email
[email protected].
Dr.Mohammed Ameer Hamza Shah
Clinical Fellow Body Imaging,
Clinical Imaging Department,
Hamad Medical Corporation.
Doha,
Qatar.
Email
[email protected]
Dr.
Zaid Waleed Noori Noori
Volunteer at Clinical Nutrition and Risk Factor Modification Center.
Toronto,
Canada.
Email
[email protected]
Dr.
Alaa Abdulsattar Al-Taie
Associate Consultant Musculoskeletal Radiologist.
M.B.Ch.B,
CABMS-RAD,
Musculoskeletal Radiology Clinical Fellowship.
Hamad Medical Corporation.
Doha,
Qatar.
Email:
[email protected]
References
1. Khawaja AT,
McLean GK,
Srinivasan V.
Successful intervention for high-output cardiac failure caused by massive renal arteriovenous fistula: a case report.
Angiology 2004; 55:205.
2. Raju,
D.,
& Rammurti,
S.
(2008).
Arteriovenous fistula following kidney biopsy.Indian Journal of Nephrology,18(2),
83.
doi:10.4103/0971-4065.42348.
3. Dönmez FY,
Coşkun M,
Uyuşur A et-al.
Noninvasive imaging findings of idiopathic renal arteriovenous fistula.
Diagn Interv Radiol.
2008;14 (2): 103-5.
4. Diddee,
Raman,
and Ian H Shaw.
“Acquired Tracheo-Oesophageal Fistula in Adults.”Continuing Education in Anaesthesia Critical Care & Pain,
vol.
6,...
