Fig. 11
From: Enterocutaneous fistulas: a primer for radiologists with emphasis on CT and MRI
Two cases of post-surgical ECF in CD. After recent ileocecal resection, in a 61-year-old man multiplanar CT-enterography (A, B) showed mural thickening with mucosal hyperenhancement (thin arrows) along distal ileum consistent with disease activity, and an ECF (arrows) coursing obliquely from the affected tract to small-sized mesogastric EFO (arrowheads); reoperation included ECF debridement, ileal resection and redo anastomosis. A 27-year-old man developed an ECF after subtotal colectomy with cecal-rectum anastomosis, with corresponding MRI (T2-weighted image C, fat-suppressed post-contrast T1-weighted image D) appearance of fluid-filled track (arrows) with peripheral enhancement (thin arrows). Prominent inflammation also affected the skin surrounding the EFO (arrowheads) and at inner aspect of the ECF: the latter corresponded endoscopically to the anastomotic site and was treated by positioning of an over-the-scope clip, allowing ECF resolution