28 year old female with history of Crohn's disease, perianal disease status post end ileostomy with parastomal abscess. Evaluate for small bowel disease or fistulous connection to abscess. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Again seen are bilateral, complex perianal transsphincteric tracts with one tract beginning at the left 5 o'clock position (series 41/35) and another beginning at the right 10 o'clock position (series 41/31) with both crossing and connecting at the posterior midline (coronal series 501/42). Both complex tracts demonstrate blind-ending bilateral superior extension, similar to prior exam. There is inferior extension of the right tract located subcutaneously in the right medial gluteal cleft and extending to the skin surface, similar to prior exam. There is blind-ending inferior extension of the left tract in the left ischioanal fossa. There has been mild interval increased size of the right-sided tract as it extends posteriorly and crosses the midline (series 401/37) and in the inferior extension in the left ischioanal fossa (sagittal series 601/26).Right lower quadrant ileostomy stoma with a minimal amount of fluid signal in the subcutaneous portion of the stoma, but no specific evidence of abscess.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Multiple bilateral, complex perianal fistulous tracts with mild interval increased size as detailed above.