52-year-old female with history of vulvar Crohn's disease. Evaluate. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Multiple inguinal and pelvic sidewall lymph nodes with the largest on the right pelvic sidewall measuring 1.5 x 1.0 cm (series 4, image 51) and left inguinal measuring 1.3 x 1.0 cm (series 4, image 44).BOWEL, MESENTERY: Partially visualized right lower quadrant ileostomy. Status post colectomy.BONES, SOFT TISSUES: There is a fistulous tract which originates at the location of the prior anal region with branching. One branch extends anteriorly to the right labia and the other branch extends posteriorly, exiting at medial right gluteal area. No evidence of drainable abscesses. Mildly increased T2 signal is present, consistent with inflammatory changes.Small volume pelvic ascites.OTHER: No significant abnormality.
1.Branching perianal fistula as detailed above.2.No drainable abscess.3.Small volume pelvic ascites.4.Prominent pelvic and inguinal lymph nodes, likely reactive in etiology.