42-year-old male with a history of Crohn's disease and ascending colon stricture. Please assess proximal bowel. ABDOMEN:LIVER, BILIARY TRACT: Gallstones without evidence of acute cholecystitis. No intra- or extra-hepatic biliary ductal dilation. No common duct stone is identified.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: There is wall thickening with associated enhancement of a short segment of ascending colon at the level of the hepatic flexure, measuring 4.0 cm in length, consistent with acute on chronic fibro-stenotic disease. Additionally, there is mild wall thickening of a short segment of the terminal ileum with associated enhancement on postcontrast sequences, consistent with acute on chronic fibro-stenotic disease, measuring approximately 5 cm in length. There are no dilated loops of bowel suggest obstruction. No fistula is identified.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: No significant abnormality noted.BOWEL, MESENTERY: There is wall thickening with associated enhancement of a short segment of ascending colon at the level of the hepatic flexure, measuring 4.0 cm in length, consistent with acute on chronic fibro-stenotic disease. Additionally, there is mild wall thickening of a short segment of the terminal ileum with associated enhancement on postcontrast sequences, consistent with acute on chronic fibro-stenotic disease, measuring approximately 5 cm in length.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Wall thickening with associated enhancement and narrowing of 4.0 cm segment of ascending colon at the level of the hepatic flexure, consistent with the stated history of a colonic stricture. These findings likely represent acute or chronic fibro-stenotic disease.2.Mild wall thickening of a 5-cm short segment of the terminal ileum is also compatible with acute on chronic fibro-stenotic disease.