History of perianal Crohn's disease. Evaluate for fistula. PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Quiescent (non-active) inflammatory bowel disease of the visualized rectosigmoid. Small reactive lymph nodes are decreased in size from the prior study.BONES, SOFT TISSUES: Approaching near and likely originating from the anterior portion of the distal rectum is a fistula tract which extends anteriorly and bifurcates at the level of the base of the penis. It progresses inferiorly along both the left and right intragluteal cleft to the skin surface. No associated fluid collection to suggest an abscess. The overall appearance is similar to the prior study.Stable left intertrochanteric T2-weighted hyperintensity.OTHER: No significant abnormality noted.
Perianal enterocutaneous fistula approaching and likely originated from the anterior portion of the distal rectum extending anterosuperiorly where it bifurcates at the level of the base of the penis and progresses inferiorly along both the left and right intragluteal cleft to the skin surface, appearing similar to the prior study. No associated fluid collection to suggest an abscess.