0:01

So a key role that we have as radiologists in

0:04

interpreting these enterographies is trying

0:05

to help our surgeons decide when a case

0:08

is appropriate for them to manage surgically.

0:11

One of the first things is that they're going to want

0:13

to know if there's a failure of medical management.

0:15

So we've talked a lot about differentiating acute

0:17

from chronic disease, and once you've limited

0:20

the acute disease to a pretty small component,

0:22

then they're going to say they've kind of

0:24

optimized medical management, and then they're

0:25

going to go based on symptoms or other findings,

0:28

which may benefit.

0:29

So if there's ongoing symptoms with

0:31

optimized medical management, those

0:33

are cases that are going to go to surgery.

0:35

But there's also other cases that may need to go to a

0:38

surgeon, even when medical management is not optimized.

0:41

And those cases would be things where there's

0:43

severe stricturing and fistulae or abscesses.

0:47

And so when we find those fistulae and abscesses

0:49

that just aren't, you know, you can't fix

0:52

a fistula with medical management because

0:54

once it's there, it's not going to go away.

0:57

And so we really need to find those

0:58

fistulae, give a description of where they

1:01

are and what they're connecting to,

1:03

to help our surgeon approach those cases.

1:05

It's an important thing.

1:06

So I'm going to go through a number of

1:07

examples of different patterns of fistulae,

1:10

how to identify them, what to look for,

1:13

and how you can help your surgeons with that.