History of Crohn's disease. Known proximal transverse colon stricture. Presents with recurrent obstructive symptoms. ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. The common bile duct measures 10 mm and tapers smoothly at the ampulla without an obstructing mass or stone. Minimal intrahepatic biliary ductal dilatation. Fatty liver without suspicious lesion or vascular abnormality.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 9 cm moderate fixed stricture of the transverse colon without significant proximal colonic dilatation. The wall appears moderately circumferentially thickened with adjacent fibrofatty proliferation and postcontrast enhancement. Additionally there is a severe stricture at the splenic flexure measuring approximately 5 cm in length again without significant proximal dilatation.The terminal ileum is well seen without wall thickening, abnormal postcontrast enhancement, fibrofatty proliferation or proximal bowel dilatation. The remainder of the small bowel is normal in caliber and overall appearance.No loculated fluid collection.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small pleural effusions.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild body wall edema.OTHER: No significant abnormality noted.
1. Acute on chronic moderate degree 9 cm proximal transverse colon stricture and severe 5 cm splenic flexure stricture. No evidence of associated large bowel or small bowel obstruction.2. The small bowel is unremarkable. No fluid collection.3. Mild biliary ductal dilatation without a focal mass or stone likely related to cholecystectomy. 