40 year-old female with a history of fistula. Presents with perirectal pain. PELVIS:UTERUS, ADNEXA: Incidental note is made of a arcuate uterus. Again seen are nabothian cysts. Again seen are left adnexal cystic lesions, appearing decreased in size compare to the prior study, likely representing physiologic ovarian follicles.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Again seen is a curvilinear focus of increased signal abnormality extending from the 12 o'clock position of the anus to the skin surface along the right medial gluteal crease consistent with the known history of trans-sphincteric perianal formation. There is also extension to the level of the posterior wall of the vagina raising the question of an entero-vaginal fistula. The previously described fluid collection/abscess is no longer visualized. A seton is in place.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Interval resolution of the previously described perianal abscess. Persistent perianal transsphincteric fistula formation extending posteriorly to the skin surface of the right gluteal crease as well as anteriorly to the level of the posterior wall of the vagina, which also appears less prominent when compared to the prior study.