57-year-old male with a history of Crohn's disease with an outside hospital CT enterography showing a 10 cm ileal stricture and proximal ileal short segment strictures with a history of intermittent obstructions and iron deficiency anemia. ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter focus with associated fluid signal intensity in segment 8 of the liver, most consistent with a simple cyst.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple simple cysts are identified bilaterally.RETROPERITONEUM, LYMPH NODES: There are multiple prominent mesenteric lymph nodes without evidence of lymphadenopathy. BOWEL, MESENTERY: There is wall thickening of a 5.4-cm segment of the terminal ileum consistent with the stated history of ileal stricture. There is associated wall enhancement on post contrast sequences consistent with active fibro-stenotic disease. Approximately 5 cm proximal to this stricture is an additional segment of distal ileum with associated wall thickening and enhancement, measuring approximately 10 cm, consistent with active fibro-stenotic disease. Immediately proximal to this segment of active disease is a segment of distal ileum which demonstrates wall thickening, without evidence of enhancement, consistent with chronic fibro-stenotic disease without active inflammation. Proximal to this segment is an additional 2 cm segment of wall thickening with enhancement, consistent with an additional segment of fibro-stenotic disease with active inflammation. There is mild distention of the distal ileum proximal to this stricture. There is no evidence of fistula formation or lymphadenopathy. There are no dilated loops of small bowel to suggest obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: There are multiple prominent mesenteric lymph nodes without evidence of lymphadenopathy. BOWEL, MESENTERY: There are multiple prominent mesenteric lymph nodes without evidence of lymphadenopathy. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Findings consistent with acute on chronic inflammatory bowel disease including multiple long segment strictures affecting the distal and terminal ileum, with measurements provided above. No fistula or small bowel obstruction is identified. 