CT Sailogram

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.

• 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.

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.

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.

• 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.

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.

• 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.

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

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.

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

• 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.

• 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.

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.

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

• Very small tracts (<1 mm) may not show.
• Active bleeding can obscure images.