32-year-old female with pain and history of Crohn's disease, status post ileocecectomy in 2002. Recent scope reveals Crohn's disease at the anastomosis with narrowing. 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: Wall thickening of the neoterminal ileum and proximal ascending colon with surrounding fat stranding and wall enhancement compatible with active disease. Associated dilated distal ileal loops proximal to the narrowed neoterminal ileum are also noted, and surrounding fibrofatty proliferation is evident. There are at least 2 fistulous connections to the inferior small bowel loops (coronal series 3 images 20, 22). No drainable fluid collection. A few areas of segmental wall thickening involving the proximal transverse colon shows no surrounding inflammatory change or wall enhancement and likely represent peristaltic contractions (coronal series 3 image 23).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Unremarkable uterus. Small left adnexal cyst.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: As above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Findings compatible with active disease of the neoterminal ileum and adjacent ascending colon as described above with proximal bowel dilation of the ileum. At least 2 fistulous connections to the inferior adjacent dilated ileal bowel loops are noted.