The differential diagnosis of small bowel fold thickening is broad. Diffuse fold thickening may be "regular and smooth" or "irregular and nodular".
On this page:
Regular, smooth generalised thickening
- oedema
- haemorrhage
- anticoagulation or bleeding diathesis
-
vasculitides
- IgA vasculitis (Henoch-Schonlein purpura)
- Buerger disease
- graft-versus-host disease (GVHD)
- haemolytic uraemic syndrome (HUS)
- disseminated intravascular coagulation (DIC)
- trauma
- cellular/proteinaceous infiltrates
- lymphoma/leukaemia
- eosinophilic enteritis: early, before becoming irregular
- amyloidosis: early, before becoming irregular
This is a long list and dividing patients by age and presentation helps somewhat.
Elderly, acute presentation: Top 3
- ischaemia (arterial or venous)
- haemorrhage (warfarin)
- ?
Elderly, chronic/asymptomatic presentation: Top 3
- oedema from CCF, hypoalbuminaemia
- lymphatic obstruction
- lymphoma/leukaemia
Young, acute presentation: Top 3
- infective
- inflammatory: e.g. Crohn disease
- vasculitis
Young, chronic/asymptomatic presentation: Top 3
- lymphoma/Leukaemia
- radiation
- inflammatory: e.g. Crohn disease
Irregular, nodular generalised thickening
- neoplasms
- metastases, especially melanoma
- lymphoma
- infection
- Giardiasis
- Whipple disease
- tuberculosis: typically terminal ileum
- Yersinia: typically terminal ileum
- Strongyloidiasis: more pronounced proximally
- inflammatory/cellular/proteinaceous infiltrate