Female; 34 years old. Reason: history of perianal fistula, perirectal abscess. h/o Crohn's. f/u from 1/2015 History: abd pain, diarrhea ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Moderate hiatal hernia, similar to prior study. Mild colonic wall thickening with increased enhancement at the junction of the descending colon and sigmoid colon (series 2201/91). Slight thickening of the wall of the terminal ileum is also seen (series 1501/1).BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Left transsphincteric perianal fistula is seen arising from the 6 o'clock position of the superior anus with complex fistulous tracts extending inferiorly toward of the skin surface at two sites in the left medial gluteal fold, similar to prior exam (series 2201/35).Increased enhancement due to granulation tissue associated with the fistula, particularly at the level of the anorectal junction, has increased (series 2201/42). BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
1. Left transsphincteric perianal fistula is similar to prior exam, aside from increased associated granulation tissue.2. Thickening and enhancement of the descending/sigmoid colon. 