What is the role of cystography in the workup of enterovesical fistula?

Updated: Dec 24, 2020
  • Author: Joseph Basler, MD, PhD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
  • Print
Answer

Cystography may demonstrate contrast outside the bladder but is less likely to demonstrate a fistula.

Radiographic signs have been described. The herald sign is a crescentic defect on the upper margin of the bladder that is visualized best in an oblique view. The herald sign represents a perivesical abscess. A "beehive on the bladder" sign is associated with the vesical end of the fistulous tract. [45]

Because of the superiority of CT scanning as a tool for diagnosis and treatment planning, plain cystography is no longer used in the evaluation of fistulae. CT scanning with rectal contrast only is the best diagnostic imaging modality.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!