Atlas of Gastrointestinal Imaging FIGURE 2.1.7 Rectal fistulas complicating ulcerative colitis

Dr. Perry Pickhardt
Aug 26, 2007
FIGURE 2.1.7 Rectal fistulas complicating ulcerative colitis. Double-contrast BE image (A) shows contrast communication with the vagina due to a rectovaginal fistula. The fistula itself involved the low rectum and is not well demonstrated on this image. Note the typical rectosigmoid features of chronic UC, including widening of the presacral space. Contrast-enhanced CT image (B) from a second patient with UC shows fistulous communication (arrowhead) between the rectum and bladder (rectovesical fistula). Note air within the bladder and the prominent bladder wall thickening from inflammation. In general, fistulas are much more common in the setting of Crohn's disease. (B from Pickhardt PJ, Bhalla S, Balfe DM: Acquired gastrointestinal fistulas: Classification, etiologies, and imaging evaluation. Radiology 2002; 224:9-23.)
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