Differential Diagnosis for CT Findings of Multiple Mildly Dilated Small Bowel Loops with Mucosal Hyperemia

• Single most likely diagnosis:
  • Viral or bacterial enteritis: This is the most likely diagnosis given the CT findings, as enteritis typically presents with inflammation of the small bowel, which can cause mild dilation and mucosal hyperemia.
• Other Likely diagnoses:
  • Food poisoning: Similar to enteritis, food poisoning can cause inflammation and irritation of the small bowel, leading to the observed CT findings.
  • Gastroenteritis: While often affecting the stomach and large bowel more prominently, gastroenteritis can also involve the small bowel, causing similar radiographic findings.
  • Partial small bowel obstruction: Early or partial obstruction can cause mild dilation of the small bowel loops without significant clinical symptoms of obstruction.
• Do Not Miss diagnoses:
  • Ischemic bowel disease: Although less common, ischemia can cause mucosal hyperemia and bowel dilation. Missing this diagnosis could lead to severe consequences, including bowel infarction.
  • Intussusception: While more typical in children, intussusception can occur in adults and may present with bowel obstruction and ischemia, making it a critical diagnosis not to miss.
  • Inflammatory bowel disease (IBD) flare: Patients with known IBD (e.g., Crohn's disease, ulcerative colitis) can experience flares that might present with similar CT findings, and missing a flare could lead to significant morbidity.
• Rare diagnoses:
  • Eosinophilic enteritis: A rare condition characterized by eosinophilic infiltration of the bowel wall, which can cause symptoms and imaging findings similar to those of enteritis.
  • Whipple's disease: A rare, systemic bacterial infection that can affect the small bowel, leading to malabsorption and inflammation, which might be visible on CT scans.
  • Lymphoma or other malignancies involving the small bowel: Although rare, these conditions can cause bowel wall thickening, obstruction, and other findings that might be confused with enteritis or other inflammatory conditions.