Differential Diagnosis for Abdominal Pain with Colon Wall Thickening
Single Most Likely Diagnosis
- Chronic Constipation: The CT findings of underdistention versus wall thickening of the colon without associated pericolic inflammatory changes could be indicative of chronic constipation, which is a common condition in adults and can cause abdominal pain.
Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): IBS is another common condition that can cause abdominal pain and alterations in bowel habits, which might be reflected in the colon wall thickening or underdistention seen on the CT scan.
- Diverticulosis: Although diverticulosis itself might not directly cause wall thickening, the presence of diverticula can sometimes be associated with changes in the colon wall, and it's a common finding in adults that can occasionally cause abdominal pain.
- Colonic Inertia: This condition involves a decrease in the movement of the colon, which can lead to constipation and potentially the observed changes on the CT scan.
Do Not Miss Diagnoses
- Colon Cancer: Although less likely given the absence of a distinct mass or significant lymphadenopathy, colon cancer can cause wall thickening and should always be considered, especially in adults presenting with abdominal pain and changes in bowel habits.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause colon wall thickening and should be considered, even in the absence of pericolic inflammatory changes, as the presentation can vary.
- Ischemic Colitis: This condition can cause abdominal pain and changes in the colon wall, including thickening, and is important to diagnose promptly due to potential serious complications.
Rare Diagnoses
- Eosinophilic Colitis: A rare condition characterized by eosinophilic infiltration of the colon wall, which can cause abdominal pain and wall thickening.
- Amyloidosis: Systemic amyloidosis can involve the gastrointestinal tract, leading to wall thickening among other symptoms, though it is a rare condition.
- Lymphoma: Gastrointestinal lymphoma can cause wall thickening and should be considered in the differential diagnosis, although it is less common than other causes of abdominal pain and colon wall changes.