31-year-old male with perianal Crohn's disease with recent perianal abscess. Evaluate for perianal fistula or abscess. PELVIS:PROSTATE/SEMINAL VESICLES: Suspected tiny fistula between the anterior rectum and the prostate noted on the diffusion weighted sequence (series 10 image 95).BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Trace free fluid in the dependent pelvis. BONES, SOFT TISSUES: Complex linear tract of fluid signal intensity extending from the left perineum extending anteriorly towards the scrotum, superiorly along the perianal soft tissues, connecting with irregular T2 fluid signal intensity in the presacral region with a thin fistulous connection to the posterior/6:00 position of the lower rectum (series 5 image 46). A separate left/5:00 position fistulous connection is also identified (series 8 image 48). The fluid tract measures 7 cm in craniocaudal length (series 6 image 40). OTHER: No significant abnormality noted.
1.Complex perianal fistula with connection at the left/5:00 position and possibly at the posterior/6:00 position. This fistula is a transsphincteric type. The fluid tract extends along the left perianal soft tissues, extends anteriorly towards the scrotum, and connects to irregular presacral fluid signal.2.There is a suspected fluid connection between the anterior rectum and the prostate.