History of rectal abscess status post seton placement. Now with increasing rectal tenderness. PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Scattered bilateral inguinal lymph nodes are upper limit of normal in size, but likely reactive.BOWEL, MESENTERY: Arising from the 5:00 position of the anal verge there is a linear focus of increased T2 signal, restricted diffusion, and enhancement reflecting a fistulous tract with a seton in place. There is no associated drainable fluid collection or abscess.At the 9:00 position in the external sphincter there is a 4 mm rim-enhancing fluid collection (series 4 image 21 and series 112 image 69) compatible with a small abscess.Remaining visualized bowel is normal in appearance. No evidence of active inflammatory disease. BONES, SOFT TISSUES: At least one rounded focus of fat signal intensity, e.g., in the right iliac bone, compatible with an intraosseous lipoma formation.OTHER: No significant abnormality noted.
1.4 mm abscess confined by external anal sphincter on right side as described.2.Perianal fistulous tract arising from the 5:00 perianal position and extending towards the intergluteal cleft.