47-year-old man with history of Crohn's with diarrhea and weight loss. ABDOMEN:LIVER, BILIARY TRACT: The liver and gallbladder appear normal. There is no intra or extrahepatic biliary duct dilatation.SPLEEN: Spleen is unremarkable.PANCREAS: No significant abnormality noted. No pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter cyst in the left renal midpole. Kidneys are otherwise unremarkable.RETROPERITONEUM, LYMPH NODES: Multiple mildly enlarged lymph nodes are seen within the mesentery. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: There are multiple areas of short segment circumferential thickening of the small bowel wall with luminal narrowing and proximal dilatation. The most significant and proximal strictured area measures approximately 3.7 cm in length in the distal jejunum/proximal ileum within the left hemiabdomen (301/13). The jejunum proximal to this affected small bowel is dilated up to 4.4 cm (301/12). Multiple additional areas of small bowel wall thickening and luminal narrowing are seen distally with skipped short segments of relatively normal-appearing small bowel. The terminal ileal wall is also thickened over a length of approximately 3.6 cm, however is seen to open on the later portions of the imaging study. These areas of small bowel wall thickening demonstrated ill-defined enhancement, mild diffusion restriction, and surrounding fibrofatty proliferation.The colon is decompressed which limits evaluation, but appears otherwise normal.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Multiple areas of small bowel inflammation and stricturing with skipped areas of normal appearing small bowel compatible with Crohn's.2.Small bowel obstruction at a 3.7cm-long area of strictured distal jejunum/proximal ileum in the left hemiabdomen.3.Inflammation and thickening of the terminal ileal wall without evidence of stricture at this site.