41-year-old female patient with history of Crohn's disease, ileocolitis, perianal abscess. ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter T2 hyperintense lesion in the right lobe of the liver is too small to characterize but likely represents a cyst.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a 6 cm segment of markedly thickened and enhancing terminal ileum, appearance consistent with active inflammation, lumen narrowed and underlying element of chronicity a consideration. There is mild fibrofatty proliferation at the terminal ileum. No evidence of small bowel obstruction. No evidence of large bowel involvement.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Endometrial stripe measures 2.0 cm. Recommend correlation with menstruation. Nabothian cyst formation. Left adnexal cyst is likely physiologic. Trace pelvic free fluid likely physiologic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a transsphincteric tract that arises from the posterior anus at the 7:00 position, extends into the intersphincteric space, traverses the external anal sphincter and terminates in a collection containing air in the ischioanal fat that measures 1.8 x 1.2 cm (series 20 image 45), compatible with history of perianal abscess with transanal drainage. Intervening more linear appearing fluid-containing tract measures 1.6 x 0.7 cm on image 50 series 20. There are mild adjacent inflammatory changes (series 20 image 45).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Acutely inflamed terminal ileum, luminal narrowing seen may be primarily secondary to aforementioned inflammation but an element of underlying chronicity is a consideration, adjacent fibrofatty proliferation present. No additional areas of inflammatory change seen.2.Right perianal transsphincteric fistula with associated abscess formation as described above.3.Likely physiologic thickening of the endometrium and adnexal cyst.