DEMONSTRATION OF RECTOSIGMOID FISTULA DYNAMIC SCINTIGRAPHIC PERITONEOGRAPHY

Intraperitoneal installation of chemotherapy through a Mediport implan ted subcutaneously in the abdominal wall is used currently for treatme nt of peritoneal metastases from ovarian, gastric and colonic carcinom a. There is a variable incidence of complications due to the procedure reported in the literature, The main predisposing factor for these co mplications is the inhomogeneous distribution of the chemotherapeutic drugs within the peritoneal cavity, We report an unusual case of a rec tosigmoid fistula that developed 6 wk following the insertion of a Bar dport subcutaneously in the abdominal wall for intraperitoneal therapy . The fistula was clearly demonstrated by dynamic scintigraphic perito neography. This is a new modification of scintigraphic peritoneography as practiced routinely, We endorse the previous recommendation that s cintigraphic peritoneography be performed before every intraperitoneal installation of a chemotherapeutic drug or radiopharmaceutical to ens ure the homogeneous distribution of the drugs and to prevent complicat ions.