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Last updated: July 7, 2025View editorial policy

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Differential Diagnosis for "Mild thickening of the rectal wall with perirectal fat stranding"

  • Single most likely diagnosis
    • Proctitis: This condition, which is an inflammation of the rectum, can cause thickening of the rectal wall and perirectal fat stranding due to the inflammatory process. It is a common condition that can result from various causes, including infections, inflammatory bowel disease, or radiation therapy.
  • Other Likely diagnoses
    • Rectal cancer: Although less common than proctitis, rectal cancer can also cause thickening of the rectal wall. Perirectal fat stranding may be seen due to tumor invasion into the surrounding fat.
    • Inflammatory bowel disease (IBD): Conditions like Crohn's disease or ulcerative colitis can affect the rectum, leading to wall thickening and perirectal fat stranding due to chronic inflammation.
    • Diverticulitis: Inflammation of a diverticulum in the rectum can cause localized wall thickening and fat stranding.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Rectal perforation: Although less common, a perforation in the rectum can lead to perirectal fat stranding due to leakage of contents into the surrounding tissue. This is a medical emergency requiring prompt intervention.
    • Abscess: A perirectal abscess can cause fat stranding and may require drainage to prevent further complications.
  • Rare diagnoses
    • Lymphoma: A rare cause of rectal wall thickening, lymphoma can involve the rectum and cause perirectal fat stranding.
    • Rectal lymphogranuloma venereum (LGV): A rare sexually transmitted infection that can cause proctitis and subsequent rectal wall thickening and fat stranding.
    • Eosinophilic colitis: A rare condition characterized by eosinophilic infiltration of the colon, which can cause rectal wall thickening and perirectal fat stranding.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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