9-year-old female with history of Crohn's disease. PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Persistent sigmoid and rectal wall thickening is again noted with mild inflammatory changes in the presacral fat. Previously described intramural and perirectal abscesses have significant decreased in size and are no longer measurable. No evidence of significant mucosal enhancement to suggest active disease. No drainable fluid collections are present.There is a enhancing tubular structure arising from the 6:00 position of the lower rectum extending to the skin surface which likely represents a rectocutaneous fistula.BONES, SOFT TISSUES: Probable small intraosseous lipoma in the left sacral ala.OTHER: No significant abnormality noted
1. Persistent sigmoid and rectal wall thickening with mild adjacent inflammatory changes in the presacral space. Interval decrease in size of intramural and perirectal abscesses.2. Enhancing tubular structure arising from the 6 clock position of the lower rectum extending to the skin surface may represent a rectocutaneous fistula, however correlation with physical exam is recommended.