Fig. 10

Two cases of spontaneous ECF complicated by abscess collections in chronic inflammatory bowel diseases. A 77-year-old man with indeterminate colitis treated by proctocolectomy and definitive ileostomy developed two ECFs, one in right hypochondrium with a sizeable superficial abscess (* in A, B) communicating (arrows) with a jejunal loop; the second, longer and more distal ECF (arrow in C) originated from the thickened ileum (thick arrow) and included a smaller subcutaneous abscess with inflamed mucosa (thin arrow). In a 59-year-old woman with fistulising CD, the ECF corresponded at CT (D) to a gas-filled track (arrow) arising from the diseased ileocolonic anastomosis (thick arrow) and reaching a subtle depressed EFO (arrowhead). Follow-up MRI including T2- (E) and post-contrast fat-saturated T1-weighted (F) showed development of a large abscess (*) with fluid content and enhancing wall along the ECF (arrows); definitive surgical treatment required extensive adhesiolysis, resection of rectum and of diseased perianastomotic bowel