Differential Diagnosis for Distention of the Right Colon and Left Collapsed Colon
- Single most likely diagnosis
- Intestinal Obstruction: This is the most likely diagnosis given the ultrasound findings of a distended right colon and a collapsed left colon. The obstruction could be due to various causes such as adhesions, hernias, or tumors, leading to the accumulation of gas and fluid in the right colon and collapse of the left colon due to the lack of intestinal content.
- Other Likely diagnoses
- Volvolus: A twist of a portion of the intestine, which could lead to obstruction and subsequent distention of the affected segment (in this case, the right colon) and collapse of the segment downstream (left colon).
- Intussusception: A condition where a part of the intestine telescopes into another part, which could cause obstruction and lead to the described ultrasound findings.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ischemic Bowel: Although less likely, ischemia of the bowel due to various causes (e.g., embolism, thrombosis, or venous thrombosis) could present with similar findings and is critical to diagnose early to prevent severe consequences, including death.
- Toxic Megacolon: A life-threatening condition that could arise from various causes, including inflammatory bowel disease or infections, leading to significant colon distention, which might be observed in the right colon with the left being collapsed due to the disease process or secondary to the toxic condition.
- Rare diagnoses
- Hirschsprung's Disease: A congenital condition characterized by the absence of ganglion cells in the distal bowel, leading to functional obstruction. While more common in neonates, it could present later in life and might show segmental distention and collapse on imaging.
- Chronic Intestinal Pseudo-obstruction: A rare condition characterized by recurrent episodes of intestinal obstruction without any mechanical cause, which could lead to the described ultrasound findings due to abnormal intestinal motility.