Reason: 20 y.o. female with likely new onset ileal Crohn's disease. Please eval for signs of small bowel Crohns disease as well as abscess formation. Abd XR suspicious for obstruction. History: N/V with colonoscopy prep, abd XR concerning for SBO ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is an approximately 15 to 20 cm segment of narrowing with hyperenhancement and bowel wall thickening, likely corresponding to acute inflammation of a strictured segment. This segment of bowel and is approximately 10 cm from the ileocecal valve. The distal 10 cm of terminal ileum appear normal. Proximal to this segment of narrowing, there is severe small bowel dilatation up to 7.2 cm, consistent with obstruction. A large amount of stools present within the colon.Small mesenteric lymph nodes are noted. No abscesses or fistulas are identified.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Narrowed 15 to 20 cm segment of distal ileum which ends 10 cm proximal to the ileocecal valve likely represents acute on chronic inflammation from Crohn's disease with stricture formation.2.Severely dilated and fecalized proximal small bowel, consistent with high-grade obstruction.Findings discussed with Dr. Rao at 4:30 PM on 5/12/2016.