Male 27 years old Reason: please evaluate for disease activity and peri-anal disease History: abdominal pain, weight loss, diarrhea 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: Multifocal areas of abnormality throughout the colon and rectum. There is a 4.0-cm segment of wall thickening, edema, mural hyper enhancement and luminal narrowing in the distal transverse colon (series 501, image 15). There is marked dilatation of the proximal transverse colon measuring up to 11.1 cm. There is a second more distal segment of severe luminal narrowing involving the descending colon which measures at least 17cm which persists throughout the study. There is mild associated mural edema and hyperenhancement. The proximal transverse colon measures 9.3 cm in dimension. The rectum is markedly abnormal with significant mural thickening, stratification and edema. There is mild engorgement of the adjacent vasa recta as well as fibrofatty proliferation. The 3 above described segments demonstrate diffusion restriction. The findings are consistent with stenotic disease with associated inflammatory changes which are most marked in the rectum.Evaluation of the terminal ileum is limited on postcontrast images however there is no significant hyperenhancement.Above average stool burden in the ascending colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild upper abdominal ascites.
1.Multifocal stenotic disease of the transverse, descending colon and the rectum with superimposed inflammatory changes which are most marked in the rectum. There is marked colonic dilatation proximal to the stenotic segments.2.Abdominopelvic ascites and diffuse anasarca.3. Evaluation for perianal disease as clinically queried is limited on this study. This would be better characterized with a dedicated pelvic MRI if clinically indicated.Findings discussed with Dr. Yarur at time of dictation 10:00 a.m. 03/30/15.