31 year old male patient with history of ileal Crohn's disease. Blood in stool. ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of acute cholecystitis. No focal hepatic lesion.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is an extrarenal pelvis on the right.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes of an ileocecectomy. The ileocolonic anastomosis appears narrowed, but patent and not significantly changed in caliber compared to the prior MRI in 2010. There is mild associated wall enhancement of the anastomosis and neo-terminal ileum as well (image 61, series 15). There is no associated small bowel wall thickening, abnormal enhancement, or restricted diffusion to suggest acute inflammation elsewhere. There is however multifocal short segment narrowing and enhancement of the distal descending colon and rectosigmoid colon, which is new from the prior study. There is fibrofatty proliferation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Narrowing and enhancement of the ileocolonic anastomosis compatible with acute on chronic disease.2.Multifocal narrowing and enhancement of the descending/sigmoid colon compatible with active inflammation.