38-year-old male with diarrhea and abdominal pain. Evaluate for recurrent Crohn's disease. Status post 2002 ileocecectomy with repair of enterovesicular fistula. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.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: Extensive mesenteric fat could represent fibrofatty proliferation with peripheralization of the small bowel loops. The neoterminal ileum shows concentric wall thickening with phlegmonous changes and mild increased wall enhancement (coronal series 14 image 371) consistent with active disease. No drainable fluid collection. The proximal jejunal loops have a normal appearance, and the mid/distal jejunal and ileal loops demonstrate mild diffuse wall thickening. There is no bowel obstruction.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: As above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.The neoterminal ileum shows concentric wall thickening with phlegmonous changes and mild increased wall enhancement consistent with active disease. No bowel obstruction or drainable fluid collection.2.Mild small bowel wall thickening seen extensively throughout the mid/distal jejunal and ileal loops suggestive of chronic disease. There is extensive fibrofatty proliferation.