History of abdominal discomfort. History of Crohn's disease 5/13/2013 biopsy with ileocecectomy. 11/10/2015 colonoscopy biopsies were negative ABDOMEN:LIVER, BILIARY TRACT: The liver dome was not included on multiple imaging sequences. The liver is normal in size morphology and signal intensity and enhancement. Several bilateral simple and lobulated cysts are noted. No suspicious liver lesion. No intra or extrahepatic biliary ductal dilatation.Cholelithiasis without evidence of acute cholecystitis within a normally distended gallbladder.SPLEEN: The spleen is normal in morphology size and signal intensity without a focal lesion.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: The small bowel is adequately distended with oral contrast. Contrast has reached the sigmoid colon.The small bowel fold pattern is unremarkable.There are surgical changes from an ileocecectomy and right hemicolectomy.The enterocolonic anastomosis is patent.Accounting for the distention attributable to the oral contrast and given the absence of a caliber differential the small bowel is not dilated. There is no abnormal wall signal intensity, thickening, restricted diffusion, or postcontrast enhancement.No perienteric inflammatory changes such as fibrofatty proliferation, vascular engorgement or mesenteric lymphadenopathy to suggest active inflammation.No fixed luminal narrowing or associated prestenotic/upstream dilatation to suggest a flow-limiting stricture.No evidence of sinus tract or fistula formation.No free fluid or loculated fluid collection.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: See discussion above.BONES, SOFT TISSUES: Best seen on the coronal T2 images is a thick-walled 8 mm fluid-filled track extending from the left lateral rectum at the 3 o'clock position through the left levator ani musculature and ischiorectal fossa terminating in the left gluteal fold, measuring up to 6 cm in craniocaudal dimension. Adjacent to the left aspect of the rectum is a 2.0 x 1.5 cm fluid collection associated with the fistula. Communication with the left fornix of the vagina may also be present from a posterior aspect.OTHER: No significant abnormality noted.
1.No evidence of active small bowel inflammation or flow-limiting fibrostenotic disease.2.Suprasphincteric fistula extending from the left lateral rectum to the left gluteal fold with possible sinus tract communicating with the left fornix of the vagina. Associated 2.0 cm left peri-rectal peripherally enhancing fluid collection. These findings are similar to the 2013 study. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.