History of bladder cancer status post cystectomy nephrectomy and chemoradiation. PELVIS:UTERUS, ADNEXA: The uterus is atrophic. The endometrium is normal in thickness. No focal abnormality.BLADDER: Status post cystectomy with right lower quadrant ileal conduit. Multiple bowel loops have descended into the surgical bed. No specific evidence of recurrence in the cystectomy bed.LYMPH NODES: No enlarged pelvic lymph nodes. In the proximal right external iliac chain there is a 1.6 cm cystic structure which may represent a postsurgical seroma. Similar finding along the left internal iliac chain.Aortic bifurcation lymph node measures 15 x 14 mm (series 1504/569). Additional prominent mesenteric lymph nodes.BOWEL, MESENTERY: Thin-walled loculated perirectal fluid collection measuring 6.9 x 4.0 cm, unchanged from previous day CT and 2/19/2015 CT.Distended fluid-filled small bowel is partially imaged. Fluid distended proximal ascending colon is partially seen. The distal rectosigmoid is decompressed. There is abrupt transition point in the pelvis where there is abnormal thickening, enhancement and restricted diffusion of the matted loops of bowel (series 1504, image 514; series 1302/408) with mass likely thickening and stellate soft tissue appearance measuring up to 4.1 x 3.3 cm suspicious for tumor. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
No significant change from the prior day's CT study, including small bowel obstruction with transition point in the pelvis where there is stellate mass-like soft tissue thickening which is suspicious for tumor. Adhesive disease is also a consideration but felt to be less likely. Stable bland-appearing loculated fluid collection in the pelvis. Aortic bifurcation and mesenteric lymphadenopathy. 