Reason: Crohn's with history of severe perianal disease, now with deep perianal fissure, possible fistula History: Pericoccygeal pain, rule out fistula abscess PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Reactive prominent inguinal lymph nodes.BOWEL, MESENTERY: Bowel wall thickening and enhancement of the rectosigmoid colon with high T2 signal in the surrounding fat tissues consistent with inflammatory changes and edema appearing similar to prior. Enhancing creeping mesenteric fat is seen in the lower abdomen.BONES, SOFT TISSUES: There is a new enhancing sinus tract beginning at the midline posterior wall of the rectum and extending along the right medial soft tissues of the thigh into the perineum and base of the scrotum. There is a peripherally enhancing abscess in the soft tissues just inferior to the perineum and posterior to the base of the scrotum measuring 1.3 x 2.1 cm. Extensive inflammatory changes and edema are seen in the perirectal fat. A smaller 1.1 cm enhancing sinus tract arises from the posterior wall of the rectum at the 7 o'clock position without fistulization.OTHER: No significant abnormality noted.
1.1.3 x 2.1 cm perineal abscess with anoperineal fistulization.2.Additional sinus tract arising from the 7 o'clock position of the rectum without fistulization. 