54-year-old female with chronic diarrhea, abdominal pain. History of vaginal fistula. Exclude small bowel Crohn's disease. Oral contrast using Volumen was also administered. Motion artifact mildly limits exam quality.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesion.SPLEEN: Spleen is unremarkable.PANCREAS: No focal pancreatic lesion identified.ADRENAL GLANDS: No adrenal nodularity or thickening.KIDNEYS, URETERS: No focal renal lesion or hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal lymphadenopathy.BOWEL, MESENTERY: There is questionable focal thickening and enhancement at the very distal terminal ileum adjacent to the ileocecal valve. There is no associated mesenteric lymphadenopathy. No fibrofatty proliferation is seen. While this enhancement may be artifactual from decompressed terminal ileal mucosal folds, superimposed acute inflammatory change in this location cannot be excluded. No other areas of abnormal enhancement, wall thickening, or other findings of acute or chronic inflammatory changes are present.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Exam mildly limited by motion artifact. 2.Questionable focal enhancement of the terminal ileum adjacent to the ileocecal valve. No other findings of acute or chronic inflammation in this location or elsewhere. While this enhancement may be artifactual from decompressed terminal ileal mucosal folds, superimposed acute inflammatory change in this location cannot be excluded. Correlation with clinical, endoscopic, and pathologic findings is recommended to exclude Crohn's disease.