36-year-old male. History of IBD and perianal abscess. Diarrhea and weight loss. Assess for small bowel disease. ABDOMEN:LIVER, BILIARY TRACT: Scattered hepatic cysts. No biliary ductal dilatation. No suspicious hepatic mass. Gallbladder sludge.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral small renal cysts. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Long segment (approximately 35 cm) of featureless distal sigmoid colon and rectum with associated circumferential wall thickening, cord like enhancement, and mild pericolonic fat stranding suggestive of acute on chronic inflammatory bowel disease. Mild fibrofatty proliferation.Small bowel is unremarkable in appearance.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Findings consistent with acute on chronic inflammatory bowel disease involving a long segment of distal sigmoid colon and rectum. 2. Two fistula tracts arising from the distal rectum terminating in two small perirectal abscesses. 