Male 27 years old Reason: Crohn's of SB and colon, s/p 4/2014 jejunal perforation with SB resection. Evaluate for recurrent Crohn's disease. History: Crohn's disease, loose bowel movements ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.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: Scattered prominent mesenteric lymph nodes.BOWEL, MESENTERY: Multiple abnormal distal jejunal/proximal ileal bowel segments demonstrating asymmetric mural thickening, increased on the mesenteric side, and mural hyper enhancement most marked on delayed phases of imaging. There are two areas of luminal narrowing in the mid bowel which persists on multiple sequences (for example series 4, image 27 and 28; series 19, image 55 and 57). The proximal segment measures 4.3 cm. The more distal segment measures at least 7.9 cm. There is focal dilatation of the segment of bowel between these two stenoses. There is no associated diffusion restriction. The appearance suggests chronic stenotic disease. There is a short segment of mural hyperenhancement and luminal narrowing involving the terminal ileum (series 14, image 76). There is no associated diffusion restriction. The appearance is suggestive of chronic stenotic disease.There is early mural hyperenhancement involving the descending/sigmoid colon (series 19, image 53 through 57) which persists on delayed phases of imaging. The appearance is suggestive of stenotic disease with a degree of acute inflammation.Multiple areas of closely apposed small bowel loops in the mid abdomen raising the possibility of adhesions. No definite evidence of fistula.There is moderate fibrofatty proliferation, particularly in the region of the jejunum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Areas of chronic stenosis predominantly involving the mid small bowel and terminal ileum. Acute on chronic inflammation of the descending/sigmoid colon.