Question
Consider the following radiological signs :
1. Claw sign in barium enema
2. Apple core sign in barium enema
3. Multiple fluid levels with absent caecal gas in plain skiagram of abdomen
4. Single large fluid and air level in plain skiagram of abdomen
Which of the above signs is/are suggestive of ileocolic intussusception?
The correct answer is
1 and 3 only
Identifying Radiological Signs of Ileocolic Intussusception
The question asks to identify the radiological signs suggestive of ileocolic intussusception from the given options.
Key Radiological Findings
Let's analyze each sign:
- 1. Claw sign in barium enema: This sign is characteristic of intussusception. During a barium enema, the barium column may show a smooth, curved filling defect, resembling a claw, as it surrounds the intussuscepted bowel (the intussusceptum). This is a key indicator.
- 3. Multiple fluid levels with absent caecal gas in plain skiagram of abdomen: This finding on a plain abdominal X-ray (skiagram) suggests small bowel obstruction. In ileocolic intussusception, the intussusception acts as an obstruction. If the obstruction is significant and ileocecal junction is involved, characteristic signs like multiple air-fluid levels in the small bowel proximal to the obstruction and potentially absent gas in the cecum can be observed.
Signs Not Typically Suggestive of Intussusception
- 2. Apple core sign in barium enema: This sign is typically associated with annular carcinoma (cancer) of the colon, specifically seen as a circumferential narrowing with mucosal irregularity. It is not a sign of intussusception.
- 4. Single large fluid and air level in plain skiagram of abdomen: While a single large fluid and air level can indicate bowel obstruction, it is less specific and often seen in conditions like ileus or other types of bowel obstruction rather than being specifically suggestive of intussusception compared to sign 3.
Conclusion
Based on the analysis, the 'Claw sign' on barium enema (1) and the signs of obstruction like multiple fluid levels with absent caecal gas on plain skiagram (3) are suggestive of ileocolic intussusception.
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Select the correct answer using the code given below :
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