Differential Diagnosis for Geeta Yadav
Single Most Likely Diagnosis
- Inflammatory bowel disease (IBD) such as Crohn's disease or ulcerative colitis: The smooth circumferential edematous bowel wall thickening involving the ascending and transverse colon is highly suggestive of an inflammatory process, which is a hallmark of IBD. The presence of hepatomegaly with grade II fatty liver could be related to the systemic effects of chronic inflammation or malabsorption associated with IBD.
Other Likely Diagnoses
- Infectious colitis: This could present with similar bowel wall thickening and edema, especially if caused by certain bacterial or viral pathogens. However, the involvement of specific segments like the ascending and transverse colon might lean more towards IBD.
- Ischemic colitis: Although less likely given the patient's age and the absence of specific risk factors mentioned, ischemic colitis can cause bowel wall thickening. It typically affects the watershed areas of the colon.
- Lymphoma or other malignancies: These can cause bowel wall thickening but are less likely given the smooth and circumferential nature of the thickening described.
Do Not Miss Diagnoses
- Intestinal obstruction: Although the bowel is described as partially distended, any cause of bowel obstruction (mechanical or dynamic) needs to be considered, especially if the patient presents with symptoms like severe abdominal pain, vomiting, or absolute constipation.
- Invasive intestinal infections (e.g., amoebiasis, strongyloidiasis): These can mimic IBD or infectious colitis but require specific treatments.
- Vasculitis: Conditions like systemic lupus erythematosus (SLE) or polyarteritis nodosa (PAN) can cause bowel ischemia or inflammation, presenting with similar imaging findings.
Rare Diagnoses
- Eosinophilic colitis: A rare condition characterized by eosinophilic infiltration of the colonic wall, which can cause bowel wall thickening.
- Behçet's disease: A form of vasculitis that can affect the gastrointestinal tract, among other systems, and cause bowel wall thickening or ulcerations.
- Graft-versus-host disease (GVHD): In patients with a history of bone marrow or stem cell transplantation, GVHD can cause gastrointestinal symptoms and bowel wall changes similar to those described.