46-year-old female patient with ileocolonic Crohn's disease status post ileocecectomy off therapy. Strictured anastomosis. Evaluate for ileal disease. ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions identified. No intra or extrahepatic ductal dilatation. The gallbladder is unremarkable.SPLEEN: No significant abnormality noted.PANCREAS: The main pancreatic duct is not dilated.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes of an ileocecectomy. There is narrowing and wall thickening of the neo-terminal ileum over a 6 cm length with mild wall enhancement near the ileocolonic anastomosis compatible with acute on chronic disease (image 733, series 16). There is upstream dilatation of small bowel. There is fibrofatty proliferation.There is multifocal narrowing of the distal descending colon and rectosigmoid colon with corresponding wall enhancement compatible with acute inflammation. Furthermore, there is a tract of signal abnormality extending from the rectosigmoid colon to a small bowel loop within the right pelvis which likely represents a fistula (image 337, series 16). BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: As described above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Stricturing and enhancement of the neo-terminal ileum with proximal focal bowel dilation compatible with acute on chronic disease.2.Multifocal narrowing and enhancement of the descending and rectosigmoid colon compatible with acute on chronic inflammation.3.Probable fistula between the rectosigmoid colon and small bowel within the right pelvis. 