51-year-old female with anorectal pain. Concern for rectovaginal fistula. PELVIS:UTERUS, ADNEXA: The uterus is normal in size. The endometrial stripe measures 5.4 mm. A metallic artifact of the left lower uterine segment is noted, and there is no metallic density of the pelvis identified on the 3/7/2013 CT exam.There is a 1.1 cm Nabothian cyst (sagittal series 7 image 21).There is a 0.8 cm Gartner's cyst (sagittal series 7 image 16).Normal right ovary containing a 1 cm follicle. The left ovary is not clearly visualized.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No discrete evidence for a rectovaginal fistula.On the postcontrast series, there is a linear enhancing structure continuing from the 7:00 position of the annulus and continuing to the adjacent midline skin (axial series 11 image 76). No correlation T2 hyperintense signal is identified in this region to suggest an active tract.BONES, SOFT TISSUES: Lower lumbar hypertrophic facet arthropathy.OTHER: Small fat-containing umbilical hernia.
1.No evidence for rectovaginal fistula.2.Findings suggestive of a chronic/fibrotic perianal enterocutaneous fistulous tract. No correlation T2 hyperintense signal is identified to suggest that this is an active tract.3.Metallic artifacts of the left lower uterine segment of unknown etiology. No metallic density was present in this region on the 3/7/2013 CT abdomen and pelvis exam. Clinical correlation is needed.