22-year-old male with left buttock abscess. Evaluate for fistulous tracts. Large condylomata are present at the anal verge that are inflamed and indurated on physical examination. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: Several enlarged lymph nodes, a left inguinal node on image 146/191 measures 1.5 x 1.5 cm, and a left obturator node measures 0.9 x 2.4 cm. These are unchanged since 8/2/08.BOWEL, MESENTERY: There is a mixed attenuation mass in the perianal region with a focus of rim enhancement surrounding fluid attenuation, compatible with an abscess. This lesion most likely contains a solid component and fluid that may be multiloculated. The lesion has increased in size since the 8/2/08 examination. The lesion in the left medial buttock measures 3 x 7.3 cm and axial image 156/171. This lesion extends craniocaudally approximately 8 cm on coronal image 26/103.No evidence of a fistula, however, MRI may be better to further determine presence of fistula/abscess.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of free fluid in the dependent pelvis.
Increased size of left buttock mixed attenuation mass which most likely represents an abscess with associated inflammatory changes. No evidence of fistulas, however, MRI may be better to further determine disease.