From the case:
Crohn disease - fistulizing (enterography)
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Mild thickening with discontinuous inflammation (skip) of the terminal ileum and complex, arborizing fistula centered in the RLQ tethering several small bowel loops together. No abscess or obstruction. Mild surrounding reactive adenopathy.
Case Discussion
Complex fistulizing Crohn's disease with arborizing entero-enteric fistulae in the right lower quadrant. This examination was performed with CT enterography technique utilizing thinner slices and a higher IV/CT contrast dose with negative (dark) oral contrast to provide the best evaluation of small bowel inflammation.