Saw-tooth appearance on barium enema is seen in:
Correct Answer: Diverticular disease
Description: Ans. D. Diverticular diseaseExplanationDiverticulosis describes the mucosal herniations through vascular entry sites into pericolic fat, often between the mesenteric and antimesenteric taeniae. Diverticulitis implies superimposed inflammation, whereas the term diverticular disease encompasses both concepts.Diverticula themselves appear as flask-like or rounded outpouchings on barium enema. When seen enface they produce ring shadows. Differentiation from a polyp is a common problem but the definitive signs are projection beyond bowel wall and presence of fluid level within it. Muscular changes result in concertina/serrated/saw tooth appearance (answer).Hinchey classification is used in grading of diverticular disease.Note the saw-tooth appearance in diverticulosis in below image of barium enema:(Option a) In annular carcinoma colon, the sign seen on barium enema is 'Napkin ring sign'.(Option b) In ulcerative colitis, the appearance on barium enema is Pipe stem colon due to lack of haustrations in colon.(Option c) In Crohn's disease, the sign seen on barium enema is 'String sign of Cantor' due to thin column of barium in strictured segment.
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