Female 21 years old Reason: abscess, worsening perianal disease History: pain, h/o perineal CD PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant ileostomy.BONES, SOFT TISSUES: Induration and edema of the soft tissues of the ischioanal fossae bilaterally.OTHER: Postsurgical changes. Previously described rim enhancing collection posterior to the vagina is again identified. This measures 2.3 x 2.7 cm (series 501, image 47), previously 2.5 x 1.3 cm. This communicates with a smaller perianal collection which measures 1.8 x 0.9 cm (series 501, image 30), previously 1.5 x 1.1 cm. There is a complex network of fistulous tracts extending from the collection. A thin tract extends from the collection to the left gluteal cleft (series 501, image 27). A second tract extends laterally into the left medial soft tissues of the ischioanal fossa (series 501, image 21). The collection also communicates with posterior wall of the vagina (series 501, image 32). Trace pelvic free fluid.
1. Perianal/perineal collections with complex network of fistulas tracts as detailed above. Overall the appearance has not significantly changed compared to prior CT 10/29/14.