History of Crohn's disease and rectal vaginal pain. PELVIS:UTERUS, ADNEXA: Anteverted anteflexed uterus. Normal endometrial canal thickness. Post cesarean section scar in the lower uterine segment. The inner myometrium/junctional zone is normal in thickness. Small cervical nabothian cysts are noted. Left adnexal simple appearing cysts are within physiologic limits.BLADDER: No significant abnormality noted.LYMPH NODES: Small inguinal lymph nodes are nonspecific and likely reactive.BOWEL, MESENTERY: There is a transsphincteric fistula tract extending from the 6:00 position of the anal canal extending leftward's in the ischioanal fossa terminating on the left gluteal cleft. There is a 2 mm associated blind-ending sinus tract along the course of the fistula. There is no associated fluid collection. Note is made of fluid/inflammatory changes along the surface of the skin in the intergluteal cleft.Small amount of free pelvic fluid in the rectouterine pouch, within physiologic limits.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Transsphincteric fistula originating at the 6:00 position of the anal canal terminating along the left gluteal cleft. No drainable fluid collection. Fluid/inflammatory changes along the surface of the skin in the intergluteal cleft.