30 year-old male with perianal mass/wart. Status post excision of condyloma with flap closure on 1/9/08. Postop day 6. Presents with feculent material at wound. Evaluate for fistula communication or abscess formation. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: There are multiple small to borderline enlarged retroperitoneal and mesenteric lymph nodes.BOWEL, MESENTERY: There are multiple mildly dilated loops of large and small bowel throughout the abdomen, probably due to ileus. This may be exacerbated by air swallowing and spasm in the sigmoid and rectum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The sigmoid and rectum are minimally distended, possibly due to spasm.BONES, SOFT TISSUES: No significant abnormality notedOTHER: There are bilateral surgical drains in the dorsolateral buttocks with subcutaneous soft tissue air and multiple superficial skin staples. These findings are compatible with history of recent surgical procedure. No abscess or fistula was found. There is subcutaneous fat stranding in the buttocks medially which may be due to a minimal cellulitis.In some cases, small fistulas are very difficult to demonstrate, especially with CT. If symptoms persist, MRI examination of the buttocks and perineum with Crohn's protocol may be helpful for further evaluation.
No evidence of abscess or fistula. Recent surgical changes in the superficial buttocks, as described above. Ileus.