A fistulogram is a specialized diagnostic imaging procedure that uses X-ray technology and a contrast material to visualize abnormal passages within the body, known as fistulas. This medical test allows healthcare providers to gain a detailed view of these connections, which can form between organs, blood vessels, or other body parts. The primary goal of a fistulogram is to provide clear images that aid in understanding the structure and function of these passages.
Purpose of a Fistulogram
A fistulogram evaluates the health and functionality of a fistula, providing information for diagnosis and treatment planning. The procedure helps identify the exact location, size, and extent of the abnormal passage. It also detects issues such as narrowing, blockages, or clotting that can impede normal flow.
This diagnostic tool frequently assesses arteriovenous (AV) fistulas or grafts, surgically created connections between an artery and a vein, often for hemodialysis patients. These access sites can develop complications like stenosis (vessel narrowing) or thrombosis (blood clots), which a fistulogram can locate. The procedure also investigates other types of fistulas, including those involving the gastrointestinal tract (e.g., between intestine loops or near the anus) and those related to infection or inflammation. Images obtained help guide interventions like angioplasty or thrombectomy, which may be performed during the same session to restore proper flow.
The Fistulogram Procedure
Undergoing a fistulogram involves several steps to ensure clear imaging and patient comfort. Patients are positioned on an X-ray table, and the area around the fistula is cleaned with an antiseptic solution. A local anesthetic is administered to numb the skin, minimizing discomfort during the procedure.
A small incision is made, and a thin, flexible catheter is inserted into the fistula, often guided by real-time X-ray imaging called fluoroscopy. Once in place, a contrast dye is injected, making blood vessels visible on X-ray images. Patients may experience a warm sensation as the contrast material enters their body, lasting a few seconds.
Multiple X-ray images are captured as the dye flows, allowing the radiologist to identify abnormalities. The imaging process takes between 30 to 60 minutes. After images are obtained, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding.
Preparing for and Recovering from a Fistulogram
Preparation for a fistulogram includes specific instructions to ensure the procedure’s safety and effectiveness. Patients are advised to refrain from eating solid foods for several hours before the appointment, though clear liquids may be permitted up to two hours prior. Discuss all current medications, especially blood thinners or diabetes medications, with the healthcare team, as adjustments may be necessary. Inform staff about any allergies, particularly to contrast materials. Patients should arrange for someone to drive them home afterward, as mild sedation might be used, and driving is restricted for at least 24 hours.
Following a fistulogram, recovery and observation are required for one to two hours to monitor the puncture site for bleeding. Patients may experience mild soreness or bruising at the site, manageable with over-the-counter pain relievers. Keep the access site clean and dry.
Avoid strenuous activities, heavy lifting, and tight clothing over the site for 24 to 48 hours to allow for proper healing. Drinking plenty of fluids after the procedure helps the body flush out the contrast dye. Contact a healthcare provider if signs of complications appear, such as excessive bleeding, increasing pain, significant swelling, fever, or infection.