Daily abdominal pain after eating. Terminal ileal inflammation seen intraoperatively during MALS release. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology, size, signal intensity and enhancement without biliary ductal dilatation, focal lesion or vascular abnormality. Status post cholecystectomy. No extrahepatic biliary ductal dilatation.SPLEEN: The spleen is normal in morphology and size without a discrete lesion. 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: There is wall thickening and hyperenhancement of at least 5 cm of the terminal ileum suggesting compatible with acute inflammation. There is surrounding inflammation involving approximately 5 x 5.6 cm (series 13/59) and fibrofatty proliferation. There is a mild tethering of the surrounding small bowel loops, enteroenteric fistulization cannot be excluded. There is no proximal bowel dilatation. No loculated fluid collection.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Suspected acute inflammatory bowel disease involving at least 5 cm of the terminal ileum with surrounding phlegmonous inflammation and mild tethering of the surrounding small bowel loops without definite fistulous communication but which cannot be entirely excluded. No loculated fluid collection.