37-year-old female patient with Crohn's disease, complicated by vesico-intestinal fistula. Evaluate for extent of disease to aid surgical planning. 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: The left kidney is atrophic. There is patchy parenchymal enhancement of the right kidney. The ureters are prominent in diameter bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Post-surgical changes of a total colectomy with an ileo-anal anastomosis. There is abnormal increased enhancement of the anus and ileoanal anastomosis compatible with active inflammation. There is a fistulous connection between the dome of the bladder with the adjacent ileal bowel loop (image 14, series 401 and image 32, series 1602). No specific evidence of bowel wall thickening or abnormal enhancement is identified of small bowel loops proximally.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: There is bilateral hydrosalpinx. BLADDER: A Foley catheter and an air/fluid level are noted within the bladder. There is a fistulous connection between the dome of the bladder with the adjacent ileal bowel loop (image 14, series 401 and image 32, series 1602). LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Post-surgical changes of a total colectomy with an ileo-anal anastomosis. There is abnormal increased enhancement of the anus and ileoanal anastomosis compatible with active inflammation. There is a fistulous connection between the dome of the bladder with the adjacent ileal bowel loop (image 14, series 401 and image 32, series 1602). No specific evidence of bowel wall thickening or abnormal enhancement is identified of small bowel loops proximally.BONES, SOFT TISSUES: A 1.9 cm cystic lesion noted posterolateral to the right of the urethra may represent a Bartholin gland duct cyst.OTHER: No significant abnormality noted.
1.Abnormal enhancement of the anus and ileoanal anastomosis is compatible with active inflammation. 2.Fistulous connection between the dome of the bladder and an adjacent ileal bowel loop.3.Patchy parenchymal enhancement of the right kidney for which infection is not excluded; correlate with urinalysis.4.Bilateral hydrosalpinx.5.Probable Bartholin gland duct cyst.