Fistulography Technique and Diagnostic Image Quality in a 3-Month-Old Infant with Saccus Regio Colli: A Case Report

Abstract

Introduction: Parents brought a three-month-old infant to the radiology installation at RSJ Prof. Dr. Soerojo Magelang. The baby's general condition was good; the baby's temperature and weight were normal, but a fistula was found in the neck that continued to ooze fluid. After taking an anamnesis, it was discovered that signs of fistula had appeared when the baby was born. However, the symptoms became more obvious when the baby could reflexively straighten the neck and head at 1 to 2 months of age.

Objective: This case report aimed to describe the technical approach to fistulography and the resulting diagnostic image quality in a 3-month-old infant with saccus regio colli,

Method: This case report approach involved three informants, comprising two radiographers and one radiologist. Data were collected through direct observation, semi-structured individual interviews using interview guides, and document review. Ethical approval was obtained from the Research Ethics Committee (Ethical Clearance No. 45/KEH/VII/2022) prior to data collection.

Result: The fistulography examination was optimized through appropriate patient preparation, positioning, and projection selection. Because the patient was uncooperative, a single oblique exposure was performed, yielding adequate diagnostic image quality with clear visualization of the fistula while minimizing radiation exposure and avoiding repeat imaging.

Conclusion: Fistulography in a 3-month-old infant with saccus regio colli requires an examination technique tailored to the patient’s condition and fistula location. In this case, appropriate preparation, patient comfort, positioning, controlled contrast administration, and selection of an oblique projection produced a diagnostically adequate image with clear visualization of the fistula despite limited patient cooperation. A single exposure was sufficient, avoiding repeat or additional exposures.

Keywords: fistulography, saccus regio colli, pediatric