Differential Diagnosis for Severe Gastric Distention and Mildly Dilated Bowel Loops on CT
Single Most Likely Diagnosis
- Mechanical Obstruction: This is the most likely diagnosis due to the presence of severe gastric distention and mildly dilated bowel loops, which are classic signs of a mechanical blockage in the gastrointestinal tract. The obstruction could be due to various causes such as adhesions, hernias, or tumors.
Other Likely Diagnoses
- Ileus: This condition, characterized by a temporary halt of the normal contractions of the bowel muscles, can lead to distention of the bowel loops and gastric distention. It can be postoperative, post-infectious, or due to medications.
- Gastroenteritis: Inflammation of the stomach and intestines, often due to infection, can cause abdominal pain, vomiting, and distention of the stomach and bowel loops.
- Constipation: Severe constipation can lead to significant distention of the bowel loops, although it might not typically cause severe gastric distention.
Do Not Miss Diagnoses
- Volvolus: A twisting of a portion of the intestine that can cut off blood flow and lead to tissue death. It's a surgical emergency and can present with severe abdominal pain and distention.
- Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially cutting off blood supply. It's more common in children but can occur in adults, often with a lead point such as a tumor.
- Ischemic Bowel: Reduced blood flow to the intestines can cause severe abdominal pain, and while it might not directly cause gastric distention, it's a critical condition that requires prompt diagnosis and treatment.
Rare Diagnoses
- Scleroderma: A chronic disease characterized by deposition of collagen, leading to fibrosis and hardening of skin and internal organs. It can cause gastrointestinal dysmotility, leading to distention.
- Amyloidosis: A condition characterized by the deposition of amyloid (a particular type of protein) in various tissues, including the gastrointestinal tract, which can lead to dysfunction and distention.
- Chagas Disease: Caused by a parasite, it can lead to gastrointestinal dysmotility and megaesophagus or megacolon in its chronic phase, although it's more common in certain geographic areas.