Male 24 years old Reason: Assess for perianal fistula and or abscess History: 24 yo with complicated SLE, admitted on 4/9/2015 with septic shock. symptoms included abd pain, n/v, diarrhea. ct imaging w/o contrast on admission with c/f possible fistula PELVIS:PROSTATE/SEMINAL VESICLES: Prostate is atrophic. Testicles are atrophic.BLADDER: The bladder is thickened and partially emptied by the indwelling Foley catheter.LYMPH NODES: There are multiple inguinal lymph nodes which are enlarged and are possibly reactive.BOWEL, MESENTERY: Mild wall thickening of the rectosigmoid. There is a midline tract extending from the anorectal junction to the gluteal crease from the 6 o'clock position.BONES, SOFT TISSUES: There is a large left gluteal defect extending to the left interpubic ramus and left posterior acetabulum, and left proximal femur. There is sclerosis of the underlying bone. There is a large fluid-filled tract and soft tissue defect. The underlying bone is considered infected.There is also destruction of the lower sacrococcygeal segments with abnormal enhancement of the soft tissues.Additional tracks also noted to the right gluteus and partially imaged is a tract to the right greater trochanter.There is a small right hip effusion.Extensive body wall anasarca.There is extensive edema of the body wall and pelvic musculatures.OTHER: Moderate amount of pelvic ascites.
1.Findings of a perianal extending to the midline gluteal crease.2.Extensive soft tissue defects in the gluteus bilaterally, left worse than right with sclerotic changes of the underlying bone.