Differential Diagnosis for Pockets of Air in Left Colon

• Single most likely diagnosis
  • Diverticulitis: This condition is characterized by inflammation of the diverticula in the colon, which can lead to the formation of pockets of air. The left colon is a common location for diverticula, making diverticulitis a likely diagnosis.
• Other Likely diagnoses
  • Colonic pseudo-obstruction: This condition involves a blockage of the colon that is not due to a physical obstruction, but rather a disruption in the normal muscle contractions of the colon. It can lead to the accumulation of air and fluid in the colon.
  • Ischemic colitis: Reduced blood flow to the colon can cause damage to the tissue, leading to the formation of air pockets.
  • Inflammatory bowel disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause inflammation and damage to the colon, potentially leading to air pockets.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Colon cancer with perforation: Although less common, a perforated colon cancer can lead to the presence of air in the colon and is a potentially life-threatening condition if not promptly diagnosed and treated.
  • Toxic megacolon: A life-threatening condition characterized by a very inflated colon, which can be associated with IBD or other conditions. It requires immediate medical attention.
  • Necrotizing colitis: A severe condition where the tissue of the colon dies due to lack of blood supply, which can lead to air in the colon wall and is potentially fatal if not treated promptly.
• Rare diagnoses
  • Pneumatosis cystoides intestinalis: A rare condition characterized by the presence of air-filled cysts in the intestinal wall, which can be benign or associated with other diseases.
  • Colonic lymphoma: A type of cancer that affects the immune cells in the colon and can cause a variety of symptoms, including the formation of air pockets in rare cases.