42-year-old female with periumbilical abdominal pain and history of Crohn's disease status post colectomy and end ileostomy. Evaluate for active disease or fistula. ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. Hepatic and portal veins are patent. No biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Mild prominence of the pancreatic duct. Pancreatic tail appears bifid. These findings are similar to prior exam.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes from total colectomy with right lower quadrant ileostomy. The distal ileum both intra-abdominal and traversing through the subcutaneous soft tissues at the site of the ostomy over a total length of approximately 17 cm demonstrates mild-to-moderate wall thickening with increased enhancement and mild adjacent edema, most compatible with active inflammatory bowel disease. No evidence of fistula or abscess.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Small amount of endometrial fluid and small right ovarian cysts, likely physiologic changes.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: As above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of nonspecific pelvic free fluid, which may be physiologic or chronically-related to postoperative change.
Findings most compatible with active inflammatory bowel disease of the distal ileum at level of ostomy. 