28-year-old man with history of Crohn's on Humira with abdominal cramping. ABDOMEN:LIVER, BILIARY TRACT: The liver appears normal in signal and morphology. There is no intra or extrahepatic biliary ductal dilatation. The gallbladder appears normal.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 fibrofatty proliferation in the region of the terminal ileum. Prominent subcentimeter mesenteric lymph nodes noted. No significant bowel wall thickening or dilated loops of bowel are noted in the abdomen. Specifically, the terminal ileum appears normal.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: An approximately 3.5 cm segment of distal descending colon and proximal sigmoid colon (17/44) appears narrowed without change throughout the examination and circumferentially enhances on postcontrast imaging. Additionally, there is circumferential enhancement of the distal sigmoid colon and the rectum over a length of approximately 6 cm (20/62). The mid sigmoid colon appears relatively spared.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Active inflammatory bowel disease involving the proximal sigmoid colon and distal sigmoid/rectum with sparing of the mid sigmoid colon. Suggestion of focal areas of involvement in the descending colon as well.2.Findings of remote inflammatory bowel disease in the region of the terminal ileum. No evidence of active terminal ileitis.