Female 27 years old with abdominal pain and bleeding and newly diagnosed Crohn's disease with perianal disease, evaluate for small bowel involvement. ABDOMEN:LIVER, BILIARY TRACT: No focal liver lesion, biliary ductal dilation, or ascites.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 an approximately 30 cm segment of abnormal distal ileum. Asymmetric wall thickening, enhancement and diffusion restriction with associated stranding of the mesentry and prominent vaso vasorum are seen throughout this segment although some skip areas are noted. Similar findings are also present within the sigmoid colon. No abscess, stricture or fistula is identified. There is increased to 2 signal at the 6:00 to 7:00 position of the rectum but no definite collection or fistula. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Multiple follicles are seen in both ovaries.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is an approximately 30 cm segment of abnormal distal ileum. Asymmetric wall thickening, enhancement and diffusion restriction with associated stranding of the mesentry and prominent vaso vasorum are seen throughout this segment although some skip areas are noted. Similar findings are also present within the sigmoid colon. No abscess, stricture or fistula is identified. There is increased to 2 signal at the 6:00 to 7:00 position of the rectum but no definite collection or fistula. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is a small amount of pelvic free fluid.
1.Evidence of active inflammation compatible with Crohn's disease involving an approximately 30 cm segment of distal ileum as well as the sigmoid colon.2.Increased T2 signal at the 6:00 to 7:00 position of the rectum but no definite collection or fistula.