Reason: Crohn's disease with colonic and peri anal involvement History: peri anal disease ABDOMEN:LIVER, BILIARY TRACT: Prominent common bile duct and mild intrahepatic biliary ductal dilatation, likely within normal limits given age and status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: Cystic lesions within the pancreatic neck, body and tail measuring up to 7 mm (7/17), likely represent side branch IPMNs. The main pancreatic duct is nondilated.ADRENAL GLANDS: Left adrenal nodularity, similar to prior CT.KIDNEYS, URETERS: Left renal cyst. Additional bilateral subcentimeter T2 hyperintensities, are also likely cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia.There is circumferential bowel wall thickening and hyperenhancement involving the anal canal and distal rectum extending approximately 7 cm in length. There is edema in the surrounding soft tissues with enhancement, indicating inflammation. No focal fluid collection or sinus tract is identified. There is otherwise a moderate amount of stool throughout the colon.No abnormal enhancement or thickening throughout the remainder of colon. The terminal ileum is unremarkable.BONES, SOFT TISSUES: OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Prominent inguinal lymph nodes.BOWEL, MESENTERY: See above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Circumferential bowel wall thickening and enhancement involving the anal canal and distal rectum is compatible with active Crohn's disease.2.Cystic lesions within the pancreas likely represent side branch IPMNs.3.Left adrenal nodularity is unchanged from prior CT.