Differential Diagnosis for Calcified Lesions in Bowel on CT Scan

Single Most Likely Diagnosis

• Appendicolith: A calcified appendicolith is a common cause of appendicitis and can be seen as a calcified lesion in the bowel on a CT scan. The presence of an appendicolith increases the risk of appendiceal perforation.

Other Likely Diagnoses

• Gallstones: Although more commonly associated with the gallbladder, gallstones can occasionally be found in the bowel, particularly in the setting of a gallstone ileus, where a large gallstone has eroded through the gallbladder into the intestine.
• Enteroliths: These are calcified masses within the intestinal lumen, often associated with conditions like Crohn's disease or intestinal diverticula. They can cause bowel obstruction.
• Phleboliths: While more commonly associated with the pelvic veins, phleboliths (calcified venous thrombi) can occasionally be mistaken for calcified bowel lesions, especially if they are located near the bowel.

Do Not Miss Diagnoses

• Malignancy with Calcification: Certain malignancies, such as mucinous adenocarcinomas of the colon, can present with calcified lesions. Missing a diagnosis of malignancy could have severe consequences.
• Infectious Causes: Certain infections, like those caused by Echinococcus (hydatid disease), can result in calcified lesions within the bowel wall, although this is rare.

Rare Diagnoses

• Lymphoid Hyperplasia with Calcification: This condition can cause multiple small calcifications in the bowel wall, particularly in children.
• Intestinal Lymphangiectasia with Calcification: A rare condition characterized by dilated lymphatic vessels in the intestinal wall, which can occasionally calcify.
• Carcinoid Tumors with Calcification: While carcinoid tumors are more commonly known for their association with desmoplastic reaction and fibrosis, some can calcify, especially those in the midgut.