Male 24 years old Reason: Crohn's disease with phlegmon evaluate for response to therapy History: Abdominal pain 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: Stable mild focal prominence of the upper collecting system of the left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Persistent mural thickening and hyper enhancement of the terminal ileum (segment measuring 4.8 cm on series 4, image 4) and ascending colon (segment measuring 4.5 cm on series 5, image 18) immediately distal to the ileocecal valve and to the level of the hepatic flexure. The appearance is suggestive of acute on chronic inflammation with interval improvement in the active inflammation compared to prior MRI study, as evidenced by decreased abnormal diffusion. These areas demonstrate luminal narrowing suggestive of stricturing with associated prestenotic dilatation of the cecum and distal ileum. There is a small residual focus of phlegmon measuring 1.6 x 1.2 cm (series 11, image 4), reduced from recent CT abdomen and pelvis where it measured 2.8 x 2.2 cm. There is no high-grade bowel obstruction. There are residual inflammatory changes within the surrounding mesentery. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Acute on chronic inflammation of the terminal ileum and ascending colon, reduced compared to prior study with associated stricturing. 2.Interval decrease in the adjacent previously described phlegmon.