Understanding Scattered Wall Thickening in the Colon: Causes & Conditions

Colonic scattered mural thickening:

- Inflammatory bowel disease. (most prominent with Crohn's Colitis)

- Infection: viral gastroenteritis (including CMV), bacterial

- Clostridium difficile colitis/toxin, Campylobacter jejuni, E. coli O157:H7 , Mycobacterium, etc..

- Diverticulitis (most commonly seen on the lower left quadrant

- Ischemic bowel disease (especially if there is segmental involvement) , both chronic or acute.

- Appendicitis

- Colonic Pseudoobstruction syndrome

- Vasculitis

- Crohn’s ileitis: Mural thickening with inflammatory “comb sign’’

- Lymphoma (often diffuse, can have target lesions; usually has marked mesenteric fat involvement as well (creeping fat or mesenteric panniculitis).

- Radiation induced bowel disease

- Sarcoidosis / Amyloidosis: Usually patchy colonic involvement. Amyloidosis may be difficult to visualize without distension (may require prone-supine and decubitus views; often affects ascending colon in elderly)

- Collagen Vascular Diseases- Behçet disease, Henoch–Schönlein purpura, polyarteritis nodosa and ulcerative colitis