History of Crohn's disease. Abdominal pain vomiting and bloating. Evaluate for active inflammation and stricture. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The small bowel is adequately distended with oral contrast.The small bowel fold pattern is preserved.There is predominantly fibrostenotic disease with mild superimposed active inflammation involving the distal terminal ileum as follows:Mild circumferential wall thickening, postcontrast enhancement and restricted diffusion of 2.5 cm of a persistently moderately narrowed terminal ileum (series 5/18). There is associated proximal/upstream dilated skip segment up to 2.7 cm in caliber involving approximately 8 cm of terminal ileum. Immediately proximal to this skip segment is a long segment of mildly circumferentially thickened, enhancing and restricting small bowel extending 15 to 20 cm proximally which demonstrates moderate fixed luminal narrowing. There is very mild fibrofatty proliferation and mesenteric inflammatory changes surrounding these involved bowel loops.Note is made of a short-segment of circumferential wall thickening of the mid-rectum which appears persistently narrowed without proximal dilatation. This may represent peristalsis, however mild active inflammation is a consideration. No evidence of sinus tract/fistula formation. No significant free fluid or loculated fluid collection to suggest an abscess.BONES, SOFT TISSUES: Left lower lobe multilobular/tubular lesion was better characterized on prior CT and may represent sequestration although superimposed infection and/or bronchial impaction cannot be excluded. Left peri-aortic cystic lesion measuring 3.6 x 2.5 cm has a benign morphology. OTHER: No significant abnormality noted.
Multi-focal fibrostenotic disease involving approximately 30 cm of the distal ileum with mild superimposed inflammation. Persistent mid rectal luminal narrowing and wall thickening may represent peristalsis although mild active inflammation is a consideration.