**Question:** String of beads appearance on abdominal X-ray is seen in –

A. Appendicitis
B. Mesenteric lymphadenopathy
C. Inguinal hernia
D. Ectopic pregnancy

**Core Concept:**

The string of beads appearance on abdominal X-ray is a radiological sign that indicates the presence of multiple small bowel loops. This sign is often associated with conditions causing bowel obstruction, as the small bowel loops become dilated and can be seen as individual beads or small round opacities on the X-ray.

**Why the Correct Answer is Right:**

The correct answer, **B. Mesenteric lymphadenopathy**, refers to the enlargement of lymph nodes in the mesentery, which is the folds of peritoneum that support the small bowel. Enlarged lymph nodes can compress and narrow the lumen of the bowel, leading to the dilated small bowel loops seen as a string of beads appearance on abdominal X-ray.

**Why Each Wrong Option is Incorrect:**

A. **Appendicitis** is an inflammation of the appendix, not a radiological sign. The string of beads appearance is not associated with appendicitis.

C. **Inguinal hernia** is a protrusion of abdominal organs through a weak point in the inguinal canal, typically causing an inguinal bulge on physical examination, not seen on X-ray.

D. **Ectopic pregnancy** is a pregnancy occurring outside the uterus, usually in the fallopian tube. The string of beads appearance is not associated with ectopic pregnancy.

**Clinical Pearl:**

The string of beads appearance on abdominal X-ray is a valuable clue that helps differentiate between various causes of bowel obstruction. In the context of mesenteric lymphadenopathy, this sign highlights the importance of considering lymphadenopathy as a cause of bowel obstruction and alerting the clinician to further investigate and confirm the diagnosis.