25 year old female. History of Crohn's status post ileocecectomy who developed postop perianal abscess with Seton placement. Patient now presents with new perianal abscess and new perianal skin tags. Need to assess pelvis for new fistulas. Patient is on Remicade. PELVIS:UTERUS, ADNEXA: 9-mm fundal intramural fibroid. Endometrial stripe is unremarkable. No adnexal masses.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Seton is noted in the left posterior perirectal soft tissues. Thin superficial subcutaneous inflammatory tract in the left perineum that is approximately 3.6 cm long, paralleling the skin surface (series 100, image 73). There is overlying skin thickening and enhancement. Post contrast imaging suggest the tract as blind ending prior to termination at the anus, although the diffusion weighted imaging does show restricted diffusion extending to the anus (but this may be phlegmon changes in adjacent skin). No extension of this tract above the levator ani.No perirectal abscess. OTHER: No significant abnormality noted.
Thin, superficial inflammatory tract in the left superficial perineum that appears to be blind-ending with no definite connection to the anus. No perirectal abscess.