Finding the right tests…
Emergency services available 24 x 7
Emergency services available 24 x 7
Finding the right tests…
X-Ray
A fistulogram maps a fistula, an abnormal tract that connects two body structures, such as two loops of bowel, or an internal organ to the skin surface. A radiologist gently threads a thin catheter into the tract's external opening and injects contrast, then takes x-rays from two angles, anteroposterior (AP) and lateral (LAT), to trace its full course in more than one plane. Fistulograms are used most often for fistulas that develop after surgery or from conditions like Crohn's disease, and around the anus. The study shows how long the tract is, whether it branches, and what it connects to, information a surgeon needs before planning repair.
The images trace the fistula's path from its external opening to wherever it ends, showing its length, any branching, and whether it connects to bowel, another organ, or an abscess cavity. The AP and lateral views together give a more complete picture of the tract's course than a single angle would. This mapping is what a surgeon uses to plan repair or drainage.
A fistulogram works on a straightforward principle: filling a tract with contrast makes an otherwise invisible passage visible on x-ray. Because a fistula is defined by connecting two structures, such as bowel to skin or bowel to bladder, tracing where the contrast goes also tells the radiologist what the tract is connected to, not just how long it is.
A fistula tract rarely runs in a straight line visible from just one angle. Taking images from the front (AP) and from the side (LAT) lets the radiologist see the tract's course in more than one plane, which matters for spotting branches or loops that a single view could hide or foreshorten.
Fistulograms are used for fistulas that develop after abdominal or pelvic surgery, for perianal fistulas often linked to Crohn's disease or a prior abscess, and for tracts connecting bowel to the skin or to another organ. The findings help decide whether a fistula needs surgery, and if so, exactly what the surgeon needs to divide, close, or route around.
A large abscess, a lot of debris in the tract, or active infection can block contrast from filling the full length of the tract, which can make the study incomplete until those are treated first.
A fistulogram maps a fistula, a tract connecting two structures, such as bowel to skin. A sinogram maps a sinus tract, which starts and ends at a single opening without connecting to another structure. Both use the same contrast technique.
You may feel pressure or mild discomfort as contrast is injected into the tract opening. It's generally well tolerated and doesn't need sedation for most people.
Yes, it can be repeated after treatment to see whether the tract has shortened, closed, or is still connected to an organ or cavity, which helps guide further care.
A large abscess or a lot of debris in the tract can block contrast from reaching the full length of the passage, which can make the images incomplete until the infection is treated.
This page is general information about the test, not medical advice. Your own report's reference ranges apply — please discuss your results with your doctor.
The imaging itself is usually done within about half an hour, though you may be at the centre longer for preparation and recovery. Ask the centre what to expect.
Ask your doctor or the centre, since instructions can depend on the location and cause of your fistula.
Yes, fistulograms are commonly used for perianal and other fistulas linked to Crohn's disease, to map the tract before surgical or medical treatment planning.