History of right lower quadrant pain and elevated CRP. History of fistula and abscess. History of regional enteritis. 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 very low T2-weighted signal moderate wall thickening and narrowing involving the terminal ileum extending approximately 3.6 cm in length (series 7 image 17 through 21). This region demonstrates moderate postcontrast enhancement. 3 cm upstream there is a similar segment of very low T2-weighted signal mild wall thickening and stricture involving 2.5 cm of the ileum. No significant restricted diffusion. There is no upstream/prestenotic dilatation. The remainder of the small bowel is relatively well distended without evidence of wall thickening, dilatation or abnormal enhancement. There is minimal fibrofatty perforation of the right lower quadrant without evidence of acute mesenteric fluid, lymphadenopathy or discrete fluid collection.There is an abnormal mural contour of the cecum which appears narrowed compatible with fibrotic change from chronic inflammation.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Mild acute bowel inflammation superimposed on chronic fibrotic stricturing disease involving approximately 10 cm of the distal ileum without significant upstream dilatation. Chronic fibrotic changes affect the cecum. No loculated fluid collection.