My CT Abdomen Results

[butt-eze]

I got the results of my CT Abdomen today. It says:

Linear soft density lesions within the ischiorectal fossa bilaterally, likely older perineal scars.

Impression: No signs of active Crohn's disease. Peroneal scars bilaterally, clincial correlation is recommended to exclude active fistulas.

So, we will be doing another colonoscopy. Those don't bother me. To my knowledge I have never had a fistula. So, what do you guys think? Do you think I might have one. It does hurt a little when I go number two. I don't have diarrhea though.

If it is a fistula will they be able to treat it during the colonoscopy procedure?

Thanks for your thoughts...:sign0085:

 

[Guts Ache]

I'm fairly new to all this so I'm not going to comment on your findings. I have a CT scan next Tuesday and according to recent blood tests have fairly active Crohns at the moment so am dreading whats going to come up.

 

[AgB621]

I don't have any good answers to your question, but when I got sick, they did a CT scan of my abdomen at the hospital and it showed absolutely nothing. Like Guts, though, my blood-work suggested active Crohn's. I think a CT may not give a complete answer. My guess is the colonoscopy will give a clearer picture of what's going on than the CT. I would ask your doctor if a fistula can be fixed during a colonoscopy, I honestly don't know if it can.

 

[Kev]

Hmmm, I dunno enuff of the 'mechanics' of your typical, garden variety endoscope.

Like, I know it has optics, and a light source, and the ability to perform biopsies.. but I don't know if it has the capacity to cauterize... I would think it would just to stop any bleeding from biopsies or polyp removal... but they may just let them heal on their own. Now, as to whether a dr could cauterize small fistulas or fissures... ????? Guess your best bet is to ask a dr. How boring!!!

 

[Colt]

CTs suck. They might pick up a big fistula but it really takes an MRI to see anything small in soft tissue. Rest assured that while it's still possible that you do have a fistula it's a small one or it would have shown on the CT. According to your results you have a good history of anal fissures though and that's much more likely if it's hurting/bleeding during your BMs. Those usually heal on their own (2-4 weeks) if they're not major tears and they're not infected.

 

[Kev]

I would think that CT's would be less able to detect fistulas, even large ones, than MRI... CT depends a lot on contrast material, blood vessels, structured walls and organs, etc.. A big fistula might show up on a CT as the 'absence' of something.
But an MRI... it should show anything that has an iron in it at all... so it should be able to discern a fistula.. if the opening, end or walls of it have any blood in or on them...

 

[butt-eze]

So, I'm still confused. Why can't they tell the difference between a scar and a fistula?
I was never told prior to this that I have a fistula. So, how could I have scarring?

Frankly, it does hurt when I have BMs. Hmmm....

 

[Kev]

Well, just a hypothesis, but I would suspect scar tissue would be absent blood flow in a lot of areas... where minor vessels were cut or damaged, and couldn't be repaired.. now, the tissue all around it would have blood flow, letting the contrast material in.. and allowing the CT to image all of it... and showing an area that has no sufficient flow to image.. does that make sense? just a wild assed guess from a total layman.. closest I've come to anything like this is the Scanning Acoustical Microscopes we used to use in electronic manufacturing. but they were more like ultra sounds.. you could see all the internal layers.. but where there was nothing.. well, it showed a void.. but not what made up the void. Sort of like you had canned goods, but they had no labels. Very poor analogy..

 

[butt-eze]

Ok, that makes sense Kev. I'm a visual person and don't do as well with medical terminology. I wish doctors could/would show us the actual images.

I just hate how vague all aspects of this disease are.

My colonoscopy is June 16th so I'll let everyone know what the results are, of course.

 

[Kev]

Well, I believe CT is short for Computerized Tomogragphy... essentially using Xray technology... but it circles the body, and moves/scans along the horizontal axis at the same time... allowing the computer to almost instantly look at all of the 'slices' (pictures) it takes.. now, x-raying something dense, like bone, is no problem. But soft tissue could be vague... hence the need to add in the (ugh) contrast stuff. If you are allergic to shellfish, be careful. the usual contrast is a derivative of shellfish.. Everytime I went for one, I had to request a 'special' formula... no shellfish involved. Just an FYI for anyone else with this allergy.

Now (and this is .. well, not reliable info at all... my memory ain't so good, OK?)
MRI ... is short for Magnetic Resonance Imaging... Tho the contraptions look a lot alike, it uses a totally different type of imaging technology... and produces a VERY powerful magnetic field... hence no metal objects with you when taking it
now, I don't know if this magnetic field holds the same implications that x-rays do to the human body... but apparently it produces better imaging than a CT.

I'm betting there are other members on the forum, either in the medical field, or just hard core health researchers (whether due to crohns or not) that can give a more accurate breakdown N analysis of either/both CT scans and MRI scans.
mine is a total laymans... and I've never felt the need to know how either works

 

[butt-eze]

I'm just wondering... is it possible it's just hemorrhoids??? I've never had those before. Not even when I was pregnant.

How can you tell the difference? And, would my CT have shown more clearly that it was hemorrhoids if it was??? Does that make sense? Please refer to my results at the top again.

 

[Jeff D.]

Depends on if they are internal or external. Even that I don't know if a CT scan would pick up on a hemmy. I get them occasionally when I sit on the toilet too long and stuff and they do hurt. I have external hemmies and they are tiny pimple like things on my butt. At least that's how my doctor described them. Just don't try to pop them because they are not pimples.lol

 

[Kev]

Well, in looking at it a 2nd time, IT may be just old scar tissue... which is what I think 'they' think it is, but they want to double check to rule out a fistula growing..

scar tissue can cause pain... it isn't as flexible N pliable.. nor as 'stretchable'.. and if my understanding of what they mean by 'bilaterally' is correct.. then that would make sense. Band or bands of scar tissue circling some or all of your ailmentary (sp?) tract... Be like oversized rubber bands wrapped around it.

Course, bilaterally may have a different connotation in medical jargon... Anyone fluent in 'doc speak'?

 

[Colt]

Perineal scars likely refers to in your rectum. The Perineum is basically the exterior part of your body around your genitals and anus. Scar tissue in the rectum would almost certainly be one of two things. Hemorrhoids or much more likely anal fissures (tears in your anus that started as ulcers or from inflammation + stretching). Bilaterally means it's going a vertical scar going along an axis from inside towards the outside.

 

[butt-eze]

Colt:
So, are pain and bleeding during BM normal symptoms? What will my doctor likely do to fix this? And should I wait until my June 13th colonoscopy to get this addressed?

 

[butt-eze]

Also, I had tearing during labor and stitches afterward. Could this be the scars they are referring to?

 

[Kev]

Well, tearing of the PC muscle, esp. between the anus and vagina could be what they are referring to. And the description of 'bilateral'.. Well, I ASSumed it meant that the 'scars' ran lateral to the 'invisible' dividing line between boths sides of the body.. but it might mean just internally N externally. Think you need to ask your doctor for a definitive answer to what this report meant when they said that, OK?

 

[Colt]

Colt:
So, are pain and bleeding during BM normal symptoms? What will my doctor likely do to fix this? And should I wait until my June 13th colonoscopy to get this addressed?

Yes, pain and bleeding as it comes out is usually a fissure (but there's a low chance of a fistula). Fissures are also usually quite small and shallow so they won't show up very well on a CT. Eyes work much better. It's actually a lot like tearing during birth. It's just originating in the other orifice. Does it have that same kind of sting?

Anal fissures often heal on their own given time but you could end up with antibiotics (maybe even just a cream depending on the location of the the tear) or if it's really bad it will just be cured with cauterization.

Often they're visible without even using a scope.

They could have been referring to your labor tears but I don't know where and how bad your tears were.

The part they are referring to is the red area just to the left (in the picture) of the sphincter muscle. It is possible that they were referring to tearing from the vagina during birth if you tore especially bad, it's possible you tore from the rectum into that area, and it's also possible that you have had a small fistula that burrowed into it.

Unfortunately that little statement didn't say where the scars started and stopped so we don't know what caused them. The doctor can look at the CT and get a much better idea of what caused the scars depending on where they are.

 

[butt-eze]

Thanks for the info Colt. I will definitely ask more questions at my next visit. I will be sure to share.