Hi, my name is Bill and I've had Crohns disease since I was 20. I am now 56.
I recently had a colonoscopy done and everything came back fine except for the narrowing of my ileum which was expected.
I had a follow up CT scan and was hoping if anybody could help interpret some of the results.
My gastroenterologist and colorectal surgeon say that I should get operated on immediately. All they said was that I have a fistula and it should be taken care of. They didn't say anything about any possible cancer whatsoever.
However, I've had fistula's before and they have closed up especially with the use of Remicade and had gone into remission for years. I'm not experiencing any significant pain and not running to the bathroom.
Here are some pertinent excerpts from my CT scan and was hoping for some advice on how to proceed. My doctor now has started me on prednisone to take for 1 month. If I don't want to go through with the surgery, he would put me on either Remicade or Humira.
Here are some of the excerpts from the CT scan:GI Tract: There are extensive, chronic-appearing inflammatory changes
involving the distal and terminal ileum. There is stricturing of the
terminal ileum with circumferential mural thickening. No resultant
obstruction however.
There is a complex fistula arising from the distal/terminal ileum with
fistulization and retraction of the adjacent sigmoid colon and ileum.
There is no evidence of abscess formation.
There is extensive submucosal fat deposition within the mid to distal
ileum with hypertrophy of mesenteric fat, in keeping with a chronic
inflammatory process.
Focal intraluminal filling defects are noted within the ileum (2:93 and
2:82) measuring up to 1.9 cm. These are incompletely characterized in
the absence of a precontrast acquisition, however focality is suspicious
for polypoid mass.
There is moderate inflammatory change and increased number of nodes
within the ileal mesentery. Jejunum and proximal ileum are normal in
appearance. Enteric contrast transits to the rectum.
IMPRESSION:
1. Extensive, chronic inflammatory changes of the distal and terminal
ileum, including nonobstructive stricture of the terminal ileum with
associated complex ileoileal and ileosigmoid fistula.
2. Two polypoid filling defects within the distal ileum measuring up to
2.0 cm. These are incompletely characterized on the current examination,
however suspicious for inflammatory or neoplastic lesions. Finding may
be further evaluated with CT enterography or direct visualization.
3. No evidence of abscess formation or free perforation.
4. Hepatic and renal cysts.
5. Nonobstructing 4 mm intrarenal calculus.
I recently had a colonoscopy done and everything came back fine except for the narrowing of my ileum which was expected.
I had a follow up CT scan and was hoping if anybody could help interpret some of the results.
My gastroenterologist and colorectal surgeon say that I should get operated on immediately. All they said was that I have a fistula and it should be taken care of. They didn't say anything about any possible cancer whatsoever.
However, I've had fistula's before and they have closed up especially with the use of Remicade and had gone into remission for years. I'm not experiencing any significant pain and not running to the bathroom.
Here are some pertinent excerpts from my CT scan and was hoping for some advice on how to proceed. My doctor now has started me on prednisone to take for 1 month. If I don't want to go through with the surgery, he would put me on either Remicade or Humira.
Here are some of the excerpts from the CT scan:GI Tract: There are extensive, chronic-appearing inflammatory changes
involving the distal and terminal ileum. There is stricturing of the
terminal ileum with circumferential mural thickening. No resultant
obstruction however.
There is a complex fistula arising from the distal/terminal ileum with
fistulization and retraction of the adjacent sigmoid colon and ileum.
There is no evidence of abscess formation.
There is extensive submucosal fat deposition within the mid to distal
ileum with hypertrophy of mesenteric fat, in keeping with a chronic
inflammatory process.
Focal intraluminal filling defects are noted within the ileum (2:93 and
2:82) measuring up to 1.9 cm. These are incompletely characterized in
the absence of a precontrast acquisition, however focality is suspicious
for polypoid mass.
There is moderate inflammatory change and increased number of nodes
within the ileal mesentery. Jejunum and proximal ileum are normal in
appearance. Enteric contrast transits to the rectum.
IMPRESSION:
1. Extensive, chronic inflammatory changes of the distal and terminal
ileum, including nonobstructive stricture of the terminal ileum with
associated complex ileoileal and ileosigmoid fistula.
2. Two polypoid filling defects within the distal ileum measuring up to
2.0 cm. These are incompletely characterized on the current examination,
however suspicious for inflammatory or neoplastic lesions. Finding may
be further evaluated with CT enterography or direct visualization.
3. No evidence of abscess formation or free perforation.
4. Hepatic and renal cysts.
5. Nonobstructing 4 mm intrarenal calculus.
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