Circumferential bowel wall thickening with luminal narrowing and mucosal enhancement of two ileal segments: terminal ileum (8.5 cm long) and the ileal loop above (9 cm long), separated by a small normal segment (3 cm long). There is an enhancing fistulous track extending from an ileal loop to the dome of the urinary bladder with a thickened and enhanced bladder wall. Note prominent mesenteric vasculature with peri-ileal inflammatory stranding and minimal adjacent effusion.