DACROCYSTOGRAPHY

                         Dacrocystography
Definition

Dacrocystography is the radiographic examination of the nasolacrimal duct following administration of contrast medium to define the lacrimal gland and nasolacrimal duct (NLD).

Indications

Epiphora (Excessive tearing)
Obstruction/Stricture
Pain & Swelling (dacrocystitis)
Infection
Tumor
Fistula
Dacrolith 

 
Contrast

The contrast is used is urographin60% or non ionic may be used.

 
Risk Factors

Allergy to contrast
Pain on injection
Ductal rupture
Extravasation of contrast
Bleeding
Granuloma formation 

Equipments

X ray unit
Fluoroscopy with spot film device
Lacrimal cannula or 18G blunt needle with polyethylene catheter
2cc syringe
Urographin
Surgical gloves
Local anaesthetic drops
Punctum dialator 

Preparation

The procedure should be explained to patient before undergoing to procedure.
All metallic ornaments should be removed
Ask for any contrast reaction
Take patient history
Complete consent form 

Procedure

The patient lies supine on the table and the plain film (AP&LAT) is taken.
First of all dilate the punctum to insert the cannula
Then the cannula is inserted into the puncta of each eye.
Anaesthetic eye drops are used for patient comfort
Then the 2ml of iodinated contrast is injected into the cannulated duct under fluoroscopic guidance and immediately spot films are taken both AP&LAT. 

Filming

Plain film skull AP and lateral are taken
After contrast :- skull AP lat and LAT oblique if required 

  CASE :--     Rt  Epiphora 👨‍⚕️👁👨‍⚕️

dacryocystogram shows cystic dilatation of right lacrimal sac (large arrow) and no fluid passage beyond level of lacrimal sac. Note normal fluid passage is acquired on contralateral side (small arrows)

       

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😊STAY SAFE STAY HAPPY 😊

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SPECIALLY THANKS
Mr. KAMLESH MEHTA 
ASSOCIATE  PROFESSOR
RADIATION   PHYSICS
GMCH, UDAIPUR