25 year old M with history of ileocecectomy and multiple small bowel resections. Now with electrolyte abnormalities and elevated CRP. Please evaluate for active Crohn's disease. ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. No focal liver lesions identified.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: The patient is status post ileocecectomy and small bowel resection. The ileocolonic anastomosis is identified in the right hemiabdomen and is patent (series 401, images 20-231) without wall thickening. The distal ileum is markedly dilated up to 9 cm in diameter, with a normal caliber colon distally and jejunum proximally, similar to the prior small bowel follow through on 12/12/13. Fibrofatty proliferation of the mesentery is noted in the right hemiabdomen. No definite areas of stricturing or abnormal bowel wall enhancement are seen. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No ascites.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: see Bowel/Mesentery section above.BONES, SOFT TISSUES: No significant abnormality noted.
Apparently chronically dilated distal small bowel, with a patent ileocolonic anastomosis. No definite areas of stricturing or abnormal bowel wall enhancement is seen to suggest sites of active acute inflammation. If there remains clinical concern, complementary small bowel follow through examination may be helpful.