CT SAILOGRAM

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About The Test

A CT SAILOGRAM, also called a Fistulogram-Sinogram, is a quick imaging test that uses low-dose X-rays and a water-soluble dye to create a clear roadmap of abnormal tunnels (fistulas or sinuses) inside the body. At Cadabams Diagnostics, the exam is carried out with modern digital fluoroscopy, keeping discomfort and radiation exposure to the absolute minimum.

What is Fistulogram-Sinogram?

  • Fistulogram maps fistulas – abnormal connections between two body parts (e.g., bowel to skin).
  • Sinogram traces sinuses – small blind-ended tracts that often drain pus or fluid.
    During the test, a tiny catheter is placed at the opening, a safe contrast dye is injected, and real-time images track the exact path, length, and side branches.

When and Who Needs to Take a Fistulogram-Sinogram?

Typical Candidates

  • People with persistent skin openings that leak fluid or pus.
  • Post-surgical patients who notice new drainage sites near scars.
  • Chronically ill patients (Crohn’s, diabetes, TB) with suspected internal tracts.
  • Dialysis patients checking arteriovenous fistula health.

Common Symptoms Prompting the Test

  • Swelling, redness, or pain near a healed wound.
  • Recurrent abscesses or foul-smelling discharge.
  • Unexplained fever linked to skin lesions.

List of Parameters

Cadabams radiologists record:

  • Length & width of the tract.
  • Branching pattern (single vs. multiple).
  • Depth & direction relative to organs.
  • Contrast leak into body cavities.
  • Flow rate – helps plan surgery.

Why This Test

  • Pre-surgical planning – shows surgeons exactly where to cut.
  • Check healing after fistula repair.
  • Rule out deeper infection spreading to bone or bowel.
  • Dialysis access surveillance to prevent clots.

When to Take Test

Benefits

Benefits of Taking the Test

  • Painless – takes 15-30 minutes.
  • Outpatient – return home the same day.
  • Accurate – 90-95 % success in mapping tracts.
  • Guides targeted therapy, avoiding unnecessary wide excisions.
  • Cost-effective compared to exploratory surgery.

Illnesses Diagnosed with CT Sialogram

  • Perianal fistulas (Crohn’s disease).
  • Pilonidal sinus.
  • Tuberculous cold abscess tracts.
  • Post-operative enterocutaneous fistulas.
  • Dialysis graft stenosis or pseudoaneurysm.

Preparing for test

Steps at Home

  • Stop blood thinners (aspirin, warfarin) 48 h prior if advised.
  • Light meal 2 h before the scan; avoid heavy greasy food.
  • Bring old reports – helps compare progress.

Day of Test

  • Wear loose, metal-free clothing.
  • Remove jewellery near the affected area.
  • Inform staff about allergies or pregnancy.

Pre-requisites

  • Recent complete blood count (CBC).
  • Kidney function test (creatinine) to ensure dye safety.
  • Written consent after explanation.

Best Time to Take the Fistulogram-Sinogram

  • Morning slots reduce fasting time.
  • At least 7 days after any acute infection to avoid flare-ups.
  • Before elective surgery – usually 1-3 days prior.

Eligibility

  • Age: Any age, including children under sedation if needed.
  • Pregnancy: Deferred unless urgent; shielding provided.
  • Severe kidney failure: Discuss with nephrologist; alternative MRI may be chosen.

Procedure for Taking a Fistulogram-Sinogram

  1. Positioning – lie on the X-ray table; affected side exposed.
  2. Cleaning – antiseptic wash around the opening.
  3. Local anaesthetic – tiny needle sting, then none.
  4. Catheter insertion – soft tube placed into the tract.
  5. Contrast injection – you may feel coolness; imaging begins.
  6. Multiple angles – table tilts, short holds of breath.
  7. Completion – catheter removed; small dressing applied.
    Total time at Cadabams: 30 – 45 minutes.

Caution Before Taking the Test

  • Inform about claustrophobia – open scanner available.
  • Carry diabetic meds – metformin may need pausing.
  • No lotions or ointments on the area to be examined.

Test Results

Results and Interpretations

Finding / ObservationDescription General Interpretation / Significance
Normal scanNo fistulas or sinuses detected; smooth, unobstructed tracts with no side branches. Indicates a healthy status with no abnormal connections or tracts.
Mild inflammationSlight tissue swelling or minor reaction at the tract site.Requires clinic follow-up to monitor for potential complications.
Abnormal massPresence of an unusual density or shadow suggesting a possible abscess or tumor.Indicates possible pathology; further diagnostic tests or interventions may be necessary.
Fistula or sinus tract Appearance of a distinct tunnel or tube connecting two body parts or ending in a blind sac.Helps in diagnosing conditions like Crohn’s disease or pilonidal sinus; guides surgical planning.
Contrast leak Contrast dye spreading into unintended body cavities or organs.Suggests a rupture or perforation; may require urgent medical attention.

Risks & Limitations

Risk How Cadabams Minimizes It
Allergic reaction to dye Pre-screening questionnaire & on-site emergency kit.
Minor discomfort Warm compress and topical numbing gel.
Infection flare-up Sterile single-use kits, prophylactic antibiotics when needed.
Radiation exposure Latest low-dose digital systems; ALARA principle applied.
Limitations
  • Very small tracts (<1 mm) may not show.
  • Active bleeding can obscure images.

Types of Fistulogram-Sinogram

  1. Standard Fistulogram – focuses on external openings.
  2. Sinogram – traces internal blind tracts.
  3. CT SAILOGRAM (hybrid) – combines CT scan with contrast for 3-D mapping.
  4. AVF Fistulogram – special protocol for dialysis access sites.

FAQs

Does it hurt?

Most patients feel only mild pressure; numbing gel keeps discomfort minimal.

Can I drive home?

Yes, if no sedation was used. Otherwise, bring a companion.

How much radiation is involved?

Less than a standard CT chest; ALARA guidelines strictly followed.

What if the tract closes before the test?

Cadabams keeps a flexible slot policy; we can reschedule quickly.

What are the next steps after the test?

Your referring doctor will receive the radiologist's report. They will review the findings, discuss them with you during a follow-up appointment, and recommend the appropriate next steps, which could range from medication to a procedure to remove a stone or other treatments.

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