38-year-old woman with history of rectal pain, evaluate for intersphincteric abscess. PELVIS:UTERUS, ADNEXA: Bilateral follicular cysts are noted. The ovaries are otherwise unremarkable. Clustered nabothian cysts are seen in the cervix.BLADDER: No significant abnormality noted.LYMPH NODES: Small inguinal lymph nodes are likely reactive. No significant lymphadenopathy noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is an area of increased T2 signal, diffusion restriction, and enhancement measuring approximately 12 x 9 x 9 mm (series 41, image 32). A T2 hyperintense tract is seen extending to this lesion from the right gluteal cleft (series 401, images 26-32) and there is linear enhancement extending to the rectal wall at the 7:00 position (series 902, image 44). Very mild presacral soft tissue edema is noted.OTHER: A very small amount of free fluid is seen in the pelvis, likely physiologic.
Fistulous tract extending from the 7:00 position of the rectum (best seen on postcontrast imaging) to the right gluteal cleft with an intersphincteric abscess seen measuring up to 12 mm.