26-year-old man with history of Crohn's disease on Infliximab, evaluate for active disease. ABDOMEN:LIVER, BILIARY TRACT: A few, scattered subcentimeter hepatic cysts noted. The liver is otherwise normal in signal and morphology.The gallbladder is normal. There is no intra or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic duct normal in caliber. No focal parenchymal lesion.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis. No focal renal lesion.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is short segment focal thickening and enhancement of the ileocecal valve (18/90) without upstream dilatation. The distal ileum appears relatively normal. Multiple areas of circumferential small bowel wall thickening with enhancement (4/13 and 4/21) are present in the mid ileum over a length of approximately 20 cm. Within this abnormally thickened small bowel, there are areas of luminal narrowing measuring 6.5 cm and 3.5 cm in length. The upstream bowel is dilated measuring up to 3.7 cm. There is fibrofatty perforation of the right lower quadrant mesentery.The colon appears relatively normal.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Approximately 20 cm of thickened, enhancing mid-ileum with areas of stricturing and dilatation suggestive of active inflammation.2.Short segment thickening and enhancement of the ileocecal valve also suggestive of active inflammation.