Postoperative radiologic follow-up of rectocolonic anastomoses : the visualization of fistulous passages after evacuation

The early postoperative study of colo-rectal anastomoses is a common diagnostic procedure with symptomatic patients which is extended to asymptomatic patients by some authors. Eighty-eight anastomotic fistulas were early diagnosed after intervention in 316 patients who underwent a water-soluble contrast enema. Four out of these fistulas (4.5%) could not be demonstrated at complete filling on X-ray, but were only opacified on radiographs taken after the spontaneous evacuation of contrast medium. The increase in endoluminal pressure due to the evacuation and the lack of balloon catheter probably play a role in allowing these fistulas to be visualized.