43-year-old woman with history of ulcerative colitis status post proctocolectomy with ileal pouch anal anastomosis 23 years ago, left ischiorectal fossa abscess status post drainage and seton placement in December 2015, please evaluate for fistulous tracts. PELVIS:UTERUS, ADNEXA: C-section scar noted. Nabothian cysts present. A simple 3.7 cm right ovarian cyst is noted, physiologic for a menstruating patient.BLADDER: No significant abnormality noted.LYMPH NODES: Mildly prominent inguinal lymph nodes noted, likely reactive.BOWEL, MESENTERY: There is a perianal seton within a transsphincteric fistulous tract extending from the 12:00 position of the rectum to the left gluteal cleft in the left ischioanal fossa. The surrounding soft tissues are indurated with increased T2 signal.Within this region (6/39) there is a questionable T2 hyperintense tract extending from the 1:00 position of the rectum to a 23 x 8 mm collection of fluid in the left labia majora (7/29) which demonstrates minimal peripheral enhancement. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Enhancing fluid collection in the left labia majora which, could represent a small abscess, but likely communicates with the rectum via a suspected (but not clearly visualized) fistulous tract.2.Seton within the left transsphincteric fistulous tract.