41 year-old female with abdominal pain. Status post colonoscopy. ABDOMEN:LIVER, BILIARY TRACT: No focal mass lesions are identified. 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: There is mesenteric lymphadenopathy in the right lower quadrant, likely reactive.BOWEL, MESENTERY: There is a long segment of distal ileum, icluding the terminal ileum which demonstrates increased T2 signal abnormality, wall thickening, and enhancement, consistent with active inflammation. There is extensive inflammatory reaction in the surrounding area as well as a fistulous network, with increased linear signal abnormality suggestive of a enterocolonic fistula extending from the terminal ileum to involve the cecum. The small bowel proximal to this area appears dilated, appearing similar to the prior study, which may reflect a partial small bowel obstruction.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: There is a long segment of distal ileum, icluding the terminal ileum which demonstrates increased T2 signal abnormality, wall thickening, and enhancement, consistent with active inflammation. There is extensive inflammatory reaction in the surrounding area as well as a fistulous network, with increased linear signal abnormality suggestive of a enterocolonic fistula extending from the terminal ileum to involve the cecum. The small bowel proximal to this area appears dilated, appearing similar to the prior study, which may reflect a partial small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Findings consistent with acute and chronic inflammatory bowel disease involving the terminal ileum with associated fistulous network, involving the terminal ileum and cecum. Dilated small bowel proximally may reflect a partial small bowel obstruction related to the aforementioned fibrostenotic disease.