Reason: Worsening of previously reported perianals abscess, fistulas History: Crohn's disease, perianal abscess with fistulas, s/p hospitalization for IV antibiotics, now with recurrent fevers for past 3 days Again seen is thickening and enhancement of the rectosigmoid colon with surrounding enhancement and high signal intensity on T2-weighted images, consistent with inflammation and edema. These findings appear less pronounced on today's study than those seen on the prior study. There is a persistent, enhancing sinus tract extending from the posterior wall of the rectum through the soft tissues of the right medial thigh into the perineum and base of the scrotum. A focus of enhancement is seen in the vicinity of the previously described abscess, however, no discrete fluid collection remains.
Persistent anoperineal fistulization with near resolution of the perineal abscess. 