35-year-old male with a history of Crohn's disease status post ileocecectomy. Presents with abdominal pain. ABDOMEN:LIVER, BILIARY TRACT: Large dependent gallstone without evidence of acute cholecystitis. No intra-or extrahepatic biliary ductal dilation. Subcentimeter hepatic cyst, unchanged.SPLEEN: Small splenule.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 consistent with the stated history of ileocecectomy. There is wall thickening and enhancement of a long segment of the neoterminal ileum, measuring approximately 4.0 cm in length, consistent with acute on chronic fibro-stenotic disease. There is prestenotic dilatation of the distal ileum proximal to this area of active disease. There is mesenteric hyperemia in the surrounding area. Again seen is a complex fistulous network in the right lower quadrant, involving multiple loops of distal ileum, appearing similar to the prior study. No fluid collection is identified to suggest abscess formation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Acute fibro-stenotic disease involving the neo-terminal ileum with measurements provided above. Again seen is a complex fistulous network in the right lower quadrant involving multiple loops of distal ileum. No evidence of abscess formation.