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Understanding Scattered Wall Thickening in the Colon: Causes & Conditions
Colonic scattered mural thickening suggests:
- Inflammatory bowel disease (especially Crohn's colitis)
- Infections: viral (CMV), bacterial (C. difficile, Campylobacter, E. coli O157:H7, Mycobacterium)
- Diverticulitis (commonly left lower quadrant)
- Ischemic bowel disease (segmental involvement, acute or chronic)
- Appendicitis
- Colonic pseudo-obstruction
- Vasculitis
- Crohn's ileitis (mural thickening with "comb sign")
- Lymphoma (often diffuse, target lesions, mesenteric fat involvement/creeping fat)
- Radiation-induced bowel disease
- Sarcoidosis/amyloidosis (patchy; amyloidosis may need prone/supine views)
- Collagen vascular diseases: Behçet, Henoch-Schönlein purpura, polyarteritis nodosa, ulcerative colitis
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