Right lower quadrant pain status post ileocecectomy with prior fistulae seen disease. Concern for stricture at anastomotic site. 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: Postsurgical changes from a ileocecectomy. The neoterminal ileum demonstrates fixed narrowing and moderate circumferential wall thickening measuring approximately 7.1 cm (series 3 image 26) with surrounding fibrofatty proliferation, restricted diffusion, reactive right lower quadrant lymph nodes and vascular engorgement. More proximally there is approximately 10 cm of mild circumferential wall thickening with hyperenhancement (series 16/370).No free or loculated fluid collection. No discrete sinus tract or fistulous tract is identified. No significant proximal bowel dilatation.The remainder of the small bowel and colon shows no discrete abnormality.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Fixed narrowing, suspicious for chronic stricture, with superimposed moderate acute mural and mesenteric inflammation involving approximally 7 cm of the neoterminal ileum. There is mild to moderate acute inflammatory changes of 10 cm of the immediately upstream small bowel.