Colon cut off sign is seen in –
Correct Answer: Acute pancreatitis
Description: Ans. is 'd' i.e., Acute pancreatitis PancreatitisA. Acute pancreatitiso Acute pancreatitis is a sudden inflammation of the pancreas. Alcoholism and gall stone are the most common causes of acute pancreatitis.o Radiological features of acute pancreatitis are : -1) Plain abdominal x-rayi) Air in the duodenal C-loopii) Senital loop sign : - A focal dilated proximal jejunal loop in the left upper quadrant.iii) Colon cut off sign : - Distention of the colon upto the transverse colon with a paucity of gas distal to the splenic flexure.iv) Gasless abdomen due to vomiting.v) Renal Halo sign : - Radiolucent sign about the left kidney.2) Contrast enhanced computerized tomograpy (CECT) is now considered the imaging modality of choice for the diagnosis and staging of acute pancreatitis due to its superb capacity for demonstrating early inflammatory changes, extrapancreatic fluid collections and panceatic necrosis. CT findings of acute pancreatitis are : -i) Focal or diffuse enlargement of the pancreas due to edema.ii) Irregular or shaggy (fuzzy) contour of pancreatic margins.iii) Heterogenous enhancement of the gland.iv) Blurring of peripancreatic fat planes with streaky soft tissue stranding densites.v) Thickening of fascial planes.vi) The presence of intraperitoneal or retroperitoneal fluid collection. The fluid collections most commonly are found in the peripancreatic and anterior pararenal spaces.B. Chronic pancreatitiso Chronic pancreatitis is chracterized by progressive pancreatic damage that eventually leads to impairment of both exocrine and endocrine functions of pancreas. Most common cause of chronic pancreatitis is alcoholism. o Radiological features of chronic pancreatitis.1) Plain abdominal x-ray :- Calcification in pancreas is pathognomonic for chronic pancreatitis. Calcification primarily represents intraductal calculi. Calcification is punctate or coarse, and it may have a focal, segmental or diffuse distribution.2) Upper gastrointestinal barium study : - Reverse 3 sign in duodenum (similar appearance may be seen in pancreatic carcinoma) due to traction on medial wall of the duodenum. The C loop of duodenum may be widened bacause of mass effect from an enlarged pancreatic head.3) Endoscopic retrograde cholangiopancreatography (ERCP) : - ERCP is the investigation of choice for chronic pancreatitic. ERCP findings of chronic pancreatitis are : -i) Diffuse pancreatic duct dilatation.ii) Beaded appearance due to alternating dilatation and stenosis - "Chain of lakes" appearance or 'string of pearl' appearance or 'hourglass' appearance.iii) Rat tail stricture of CBD: - Long smooth narrowing of the CBD with graded tapering of the distal segment due to periductal fibrosis.iv) Small, round or oval, pancreatic parenchymal cavities.v) Intraluminal filling defects due to protein plugs or calculi.
Category:
Radiology
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