25-year-old female patient perirectal pain and drainage. Evaluate for perirectal abscess. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: There are scattered mildly enlarged perirectal lymph nodes. BOWEL, MESENTERY: Redemonstration of a fistula originating at the 11 o'clock position of the distal rectum (to the right), coursing anteroinferiorly, and terminating in the skin of the right labia. No evidence of associated abscess. A fistula originating at the 6 o'clock position of the distal rectum without definite fluid collection also appears similar to the prior study. There is bowel wall thickening, increased T2 signal, restricted diffusion, and enhancement of the rectum compatible with active disease. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is a new small amount of presacral fluid. No perirectal abscess is identified.
1.Rectal bowel wall thickening with signal abnormality and enhancement compatible with active disease. 2.New small amount of presacral fluid, but no definite perirectal abscess.3.Similar appearance of fistulae to prior exam. 