Reason: y.o. female with a h/o crohn's disease s/p ileocecectomy in 2005, now with intermittent abd pain, N/V. Colonoscopy was concerning for narrowing but repeat imaging showed no thickening/narrowing. Please eval for active disease, stricture, or adhesions. History: intermittent abd pain, N/V ABDOMEN:LIVER, BILIARY TRACT: Mild hepatomegaly. Diffuse loss of signal on out of phase images suggest hepatic steatosis.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: Postsurgical changes of ileocecectomy with a side-to-side anastomosis in the right lower quadrant.There is a long segment of mural hyperenhancement extending from the mid descending colon to the distal sigmoid colon which demonstrates diffusion restriction. There is irregular narrowing within this segment. No evidence of obstruction.There is a short segment of narrowing involving the distal neoterminal ileum measuring 2.3 cm in length with mild proximal dilatation up to 2.9 cm.Short segment of narrowing with mural hyperenhancement of the mid transverse colon.BONES, SOFT TISSUES: Mild ventral diastases.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Multiple nabothian cysts. Small amount of free fluid in the pelvis.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Long segment of mural hyperenhancement involving the mid and distal descending colon and sigmoid colon as well as a short segment in the mid transverse colon, suggestive of active disease.2.Short segment of narrowing of the distal terminal ileum with mural hyperenhancement likely represents stenosis with acute on chronic disease. There is mild proximal small bowel dilatation to the segment.