Differential Diagnosis for Small Bowel Obstruction with Multiple Strictures

• Single most likely diagnosis
  • A. Crohn's Disease: This is the most likely diagnosis due to the presence of multiple strictures in the ileum, which is a common feature of Crohn's disease. Crohn's disease is a type of inflammatory bowel disease (IBD) that can cause chronic inflammation, scarring, and narrowing of the bowel, leading to obstruction.
• Other Likely diagnoses
  • C. Intestinal lymphoma: Intestinal lymphoma can cause multiple strictures and obstruction, especially if the tumor is large and infiltrative. However, it is less common than Crohn's disease and typically presents with other symptoms such as weight loss and abdominal mass.
  • Other causes of small bowel obstruction, such as adhesions, hernias, or volvulus, are less likely given the presence of multiple strictures, but should still be considered.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Intussusception: Although rare in adults, intussusception can cause small bowel obstruction and is a medical emergency. It is essential to consider this diagnosis, especially if the patient presents with sudden onset of abdominal pain and vomiting.
  • Malignant tumor, such as B. GIST (Gastrointestinal Stromal Tumor): While GIST is a rare tumor, it can cause small bowel obstruction and has a high malignant potential. It is crucial to consider this diagnosis to ensure timely treatment and prevent tumor spread.
• Rare diagnoses
  • Eosinophilic gastroenteritis: A rare condition characterized by eosinophilic infiltration of the bowel wall, which can cause strictures and obstruction.
  • Amyloidosis: A rare condition that can cause bowel obstruction due to amyloid deposition in the bowel wall.
  • Other rare causes of small bowel obstruction, such as congenital abnormalities or parasitic infections, should also be considered in the differential diagnosis.