39-year-old male with pelvic abscesses and JP drains. Evaluate abscesses. Evaluation suboptimal without IV contrast.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Again noted is a loculated air-containing fluid collection located just superior to the bladder which measures 4.5 x 3.5 cm (series 6, image 17); this collection measured 4.2 x 5.0 cm on the recent CT and is decreased in size compared to the previous MRI examination. No definite fistulization with the adjacent bowel is identified however confirmation with fluoroscopy is recommended. At site of previously seen left lower quadrant fluid collection is a drainage catheter, collection has essentially resolved. Presacral fluid collection measures 3.1 x 2.5 cm (series 6, image 26), previously measuring 3.1 x 2.6 cm on the recent CT examination. There is a JP drain within this collection. Originating at the 6:00/posterior anal canal is a fistula tract which bifurcates and progresses dorsally in the bilateral gluteal subcutaneous fat. On the right the tract bifurcates with one component terminating along the medial right gluteal cleft (series 901/17). The other component on the right progresses dorsally and terminate at an additional paramedial site on the skin. This right tract is not significantly changed.The left sided fistulous tract that terminated along the left medial gluteal fold has resolved compared to the previous examination.BONES, SOFT TISSUES: Partially imaged scrotal fluid, suspicious for hydrocele formation.OTHER: No significant abnormality noted.
1. Evaluation suboptimal without IV contrast. 2. When compared to most recent CT exam and accounting for differences in technique, stable to mildly decreased size of pelvic collections in presacral space (associated drainage catheter seen) and superior to bladder. Latter collection now contains more fluid and less air. No definite fistulization to the adjacent bowel is identified, however evaluation with fluoroscopic examination should be considered for further assessment. Additional left lower quadrant collection at site of a second drainage catheter has essentially resolved. 3. Complex right-sided fistulous tract originating at the 6:00/posterior aspect of the anal canal is not significantly changed.4. Interval resolution of the left sided fistulous tract that terminated along the left medial gluteal fold.