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Fig. 8 | Insights into Imaging

Fig. 8

From: Enterocutaneous fistulas: a primer for radiologists with emphasis on CT and MRI

Fig. 8

Two cases of spontaneous, low-output ECF in CD. In a 59-year-old man with a history of ileocecal resection nearly 20 years earlier, CT (A, B) identified a right-sided ECF as an enhancing “tram-track” fistula (arrows) with mucosal hyperenhancement (thin arrow), which departed from the thickened preanastomotic ileum (thick arrow) with recurrent CD and crossed the abdominal wall and subcutaneous fat to the EFO (arrowheads); repeated ileocolonic resection and ECF debridement were performed

In a 62-year-old woman with several surgeries, water-enema CT (C, D - note distended rectosigmoid colon with rectal tube) showed a paramedian hypogastric ECF with mucosal hyperenhancement (thin arrow) and focally depressed EFO (arrowheads), communicating with the collapsed ileum; the patient did well on infliximab therapy

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