‘Thumb print’ appearance on Barium enema is found in: September 2003
**Core Concept**
The 'thumb print' appearance on a Barium enema is a radiological sign associated with a specific condition affecting the colon. This sign is indicative of a mass or a lesion within the wall of the colon that causes a localized indentation, resembling a thumb print.
**Why the Correct Answer is Right**
The 'thumb print' appearance is typically seen in cases of **colorectal carcinoma**. The mass or tumor within the colonic wall causes a localized indentation, which appears as a 'thumb print' or a crescentic filling defect on the barium enema. This is due to the tumor's infiltration into the muscularis propria of the colon, leading to a focal loss of the normal haustral folds.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option might be incorrect because the 'thumb print' appearance is not typically associated with **inflammatory bowel disease** (IBD), such as Crohn's disease or ulcerative colitis, which usually present with different radiological features like cobblestoning or skip lesions.
* **Option B:** This option might be incorrect because **diverticulosis** typically presents with rounded or oval outpouchings of the colonic wall, rather than a smooth, rounded 'thumb print' appearance.
* **Option C:** This option might be incorrect because **polyps** are usually small, rounded, or pedunculated lesions that do not cause a significant indentation of the colonic wall.
**Clinical Pearl / High-Yield Fact**
The 'thumb print' appearance on a Barium enema is a classic sign of colorectal carcinoma, and its presence should prompt further investigation with colonoscopy or biopsy to confirm the diagnosis.
**Correct Answer: A. Colorectal carcinoma.**