Wk 5, Case 1 - Review

PATIENT HISTORY: Evaluation for Crohn’s

MRI ABD PELVIS ENTEROGRAPHY W WO IV CONTRAST

INDICATION: Evaluation for Crohn’s.

COMPARISON: None.

TECHNIQUE: MR images of the abdomen and pelvis were obtained before and after the administration of intravenous contrast. Oral hyperosmolar agent was also given prior to scanning.

FINDINGS:

Liver: Unremarkable.

Gallbladder and biliary tree: Unremarkable.

Pancreas: Unremarkable.

Spleen: Unremarkable.

Adrenal glands: Unremarkable.

Kidneys: Unremarkable.

GI tract/peritoneum: There is a multifocal moderate wall thickening with intramural edema and stratified segmental mural hyperenhancement involving the distal ileum (approximately 15 cm in length) and terminal ileum (approximately 8 cm in length). There are rim-enhancing mesenteric fluid collections adjacent to the inflamed distal ileum measuring 2.0 x 2.5 cm, 3.7 x 2.3 cm and 1.6 x 1.4 cm. These measurements include the thickened walls of the collections, with the amount of internal fluid/debris less than the given measurements.

Abdominal and pelvic lymph nodes: Multiple prominent mesenteric lymph nodes are present, likely reactive.

Pelvis: No mass.

Musculoskeletal system and soft tissue: No aggressive osseous lesion.

IMPRESSION:

1. Active inflammation of the distal and terminal ileum as described, compatible with Crohn's disease.

2. Mesenteric abscesses.