Differential Diagnosis

The following differential diagnosis is based on the provided CT scan results and clinical history.

• Single most likely diagnosis
  • Viral gastroenteritis: The patient's symptoms of abdominal pain, nausea, vomiting, diarrhea, and fever, combined with the CT findings of mildly prominent fluid-filled loops of small bowel, suggest a diagnosis of viral gastroenteritis. The absence of other significant findings, such as bowel obstruction or free intraperitoneal fluid, also supports this diagnosis.
• Other Likely diagnoses
  • Infectious colitis: The patient's symptoms and CT findings could also be consistent with infectious colitis, particularly given the presence of fever and abdominal pain.
  • Inflammatory bowel disease (IBD): The CT findings of mildly prominent fluid-filled loops of small bowel and the patient's symptoms could also suggest IBD, although the absence of other characteristic findings, such as bowel wall thickening or perienteric stranding, makes this diagnosis less likely.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Mesenteric ischemia: Although the CT findings do not suggest bowel ischemia, this diagnosis is critical to consider given the patient's symptoms of abdominal pain and the potential for severe consequences if missed.
  • Appendicitis: Although the appendix appears nondilated on the CT scan, appendicitis is a critical diagnosis to consider in patients with abdominal pain, particularly if the pain is localized to the right lower quadrant.
  • Sepsis: The patient's symptoms of fever, abdominal pain, and diarrhea could suggest sepsis, particularly if the patient has a underlying infection or is immunocompromised.
• Rare diagnoses
  • Lymphoma: The patient's splenomegaly and absence of other significant findings could suggest a diagnosis of lymphoma, although this would be an uncommon presentation.
  • Sickle cell disease: The patient's splenomegaly and bone islands in the femoral heads could suggest a diagnosis of sickle cell disease, although this would be an uncommon presentation in an adult patient without a known history of the disease.