43-year-old female. Crohn's disease, status post complete colectomy with ileostomy. Report from outside hospital shows a 3 x 3 cm mass containing gas adjacent to ileostomy compatible with probable abscess. Pus from JP drain. Evaluate for abscess. Evaluate for new fistula. ABDOMEN: LUNG BASES: No significant abnormality noted. LIVER, BILIARY TRACT: No significant abnormalities seen within the liver or gallbladder. SPLEEN: No significant abnormality noted. KIDNEYS, URETERS: No significant abnormality noted. ADRENAL GLANDS: No significant abnormality noted. PANCREAS: No significant abnormality noted. Prominent pancreatic duct is unchanged.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal nodes. Small mesenteric nodes identified as well. Several mildly enlarged nodes adjacent to ostomy site are probably reactive. BOWEL, MESENTERY: There is a percutaneous drain in the anterior abdominal wall which has resolved the loculated fluid collection in the subcutaneous fat at the site of the ileostomy. No new abscess. BONES, SOFT TISSUES: No significant abnormality noted. OTHER: No significant abnormality noted. PELVIS: UTERUS, ADNEXAE: Patient is status post hysterectomy. There is a 2.6 x 3.7 cm cystic mass in the right adnexa (image 109/150 series number 3). This is this was present on the prior examination and it appears slightly smaller. If indicated the mass may be further evaluated with transvaginal ultrasound or MRI. The left adnexa is unremarkable. BLADDER: Unremarkable LYMPH NODES: No significant abnormality noted. BOWEL, MESENTERY: Right lower quadrant ileostomy is present compatible with patient's known Crohn's disease and total colectomy. Stable multiple loops of small bowel with wall thickening in the pelvis. No intraperitoneal abscess and no bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted. OTHER: No other significant abnormality was found.
1. Status post colectomy with right lower quadrant ileostomy. Status post drainage of abscess lateral to ostomy site. Thickening of pelvic small bowel loops is stable. No new abscess or fistula. 2. Stable right adnexal mass. If indicated, transvaginal ultrasound or MRI would be helpful in further evaluating this lesion. 