Female 40 years old with known Crohn's disease (ileum) - reevaluate disease and also history of hip 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: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a long, 9 cm segment of terminal ileum that demonstrates wall thickening, submucosal fat deposition, apparent decreased distensibility and avid enhancement indicating acute on chronic inflammation (coronal image 18, series 7). Proximal to this is an approximately 3 cm segment of normal-appearing ileum is seen, consistent with a skip area. On initial imaging sequences, region proximal to this skip area was incompletely distended with possible enhancement, suspicious for additional short segment site of disease; however as the exam progressed the lumen expanded allowing for better evaluation and this segment appeared normal (image 382 of series 1700).There is mild tethering of distal ileal loops (image 22 series 7) in lower mid abdomen, may be due in part to nonobstructive adhesive disease. Separation of bowel loops (most pronounced in right lower quadrant) indicative of fibrofatty proliferation.PELVIS:BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Cystic changes are noted bilaterally in the breasts which would be better evaluated with mammography.
1.Long segment (measuring 9 cm) of acute on chronic inflammation of the terminal ileum.2.Mild tethering of distal ileal loops and evidence of fibrofatty proliferation.3.Cystic changes in both breasts would be better evaluated with mammography.