Differential Diagnosis for CT Findings
The following differential diagnosis is based on the provided CT impression and narrative:
- Single Most Likely Diagnosis
- Nonspecific gastroenteritis: The CT findings of mild fluid distention of the stomach, small intestine, and cecum, along with mucosal hyperenhancement in the small bowel, are consistent with a diagnosis of nonspecific gastroenteritis. The patient's symptoms of generalized abdominal pain and diarrhea also support this diagnosis.
- Other Likely Diagnoses
- Viral or bacterial colitis: The questionable mucosal hyperenhancement in the colon could be indicative of a colitis, which could be caused by a viral or bacterial infection.
- Hepatic steatosis: The CT findings of mild diffuse hepatic steatosis are consistent with a diagnosis of fatty liver disease.
- Splenomegaly and hepatomegaly of unknown etiology: The progression of splenomegaly and hepatomegaly since the previous CT scan could be indicative of an underlying condition such as a hematologic disorder or a storage disease.
- Do Not Miss Diagnoses
- Appendicitis: Although the appendix appears normal on the CT scan, appendicitis can sometimes be missed, especially if the appendix is not well-visualized. It is essential to consider this diagnosis, especially given the patient's symptoms of abdominal pain.
- Bowel obstruction: The CT scan does not show any evidence of bowel obstruction, but this diagnosis should be considered, especially if the patient's symptoms worsen or if there are any changes in bowel habits.
- Inflammatory bowel disease (IBD): The CT findings of mucosal hyperenhancement in the small bowel and colon could be indicative of IBD, such as Crohn's disease or ulcerative colitis.
- Rare Diagnoses
- Liver cyst or hemangioma: The tiny hypodense lesion in the liver could be a cyst or hemangioma, although it is too small to characterize.
- Bone metastases: The tiny sclerotic foci in the bilateral femoral heads and right acetabular region could be indicative of bone metastases, although they are more likely to be benign bone islands.
- Infectious or inflammatory conditions: The CT findings could be indicative of an infectious or inflammatory condition, such as diverticulitis or a pancreatic infection, although these diagnoses are less likely given the patient's symptoms and the CT findings.