69-year-old male with a history of Crohn's disease status post ileocecectomy with multiple subsequent small bowel obstructions. Intermittent abdominal pain. Scout radiograph showed a nonobstructive bowel gas pattern and scattered surgical clips.Transit time to the colon was approximately 30 minutes. Fluoroscopic evaluation showed postoperative changes of prior ileocecectomy normal mucosa throughout the small bowel, with no ulcers, sinus tracts, or fistulae. The ileocolonic anastomosis appears widely patent without evidence of significant stenosis, obstruction, or fistula formation. No separation of bowel loops was present to suggest fibrofatty proliferation. There are angulated loops of small bowel in the left and right lower quadrant which may represent mild nonobstructive adhesive disease. This corresponds to the findings seen on prior CT examination dated 7/26/2014, although this was not seen on the subsequent CT examination dated 2/9/2015 or MRI enterography dated 8/2/2014. No internal hernias or ventral hernias were evident. The ascending colon was otherwise grossly normal. Air augmentation to the level of the proximal to mid ileum demonstrates a widely patent ileocolonic anastomosis without evidence of ulceration or definitive mucosal lesion.TOTAL FLUOROSCOPY TIME: 5 minutes and 45 seconds.
1. Postsurgical changes of prior ileocecectomy. The ileocolonic anastomosis appears widely patent without evidence of significant stenosis or obstruction. No findings to suggest active ulcerative or fibro-stenotic disease. 2. There are loops of mildly angulated bowel in the left and right lower quadrant, likely representing mild nonobstructive adhesive disease.