Female 25 years old Reason: 25 y.o. female with a h/o Crohn's colitis, with severe perianal fissure with likely fistula. Please evaluate for perianal; fistula and extent of colonic involvement. Past exams with motion artifact. NEEDS ANESTHESIA, SIGNIFICANT MENTAL DELAY. History: perianal fissure, possible fistula. PELVIS:UTERUS, ADNEXA: Uterus is normal in morphology. Adnexa are without diagnostic abnormality.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse thickening of the colon with increased vascularity compatible with a colitis. It involves the anus, rectum and imaged sigmoid and descending colon.BONES, SOFT TISSUES: There is a fistulous tract from the anorectal junction arising at approximately the 7:00 position that extends posteriorly to the skin. An anterior tract extending from the 1:00 position bifurcates into 2 tracts with one extending to the perineum and the other extending more anteriorly to the perineum near the posterior vagina.No abscess is evident.OTHER: No significant abnormality noted.
1.Colitis involving the imaged rectosigmoid colon2.2 perianal fistula, 1 with a branching component extending to the perineum as detailed above. No associated abscess.