Image Based Question-67299

A 30 yearold male presents with complains of chronic diarrhoea (sometimes bloody) associated with tenesmus, pain and fever.Abdominal X ray shows the following features.What is the most probable diagnosis?

A. Ulcerative Colitis.

B. Intestinal Perforation.

C. Intestinal Obstruction.

D. Paralytic Ileus.

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Correct Answer » A Explanation

Ans:A. Ulcerative Colitis.

Abdominal X ray in the image shows:

• yellow arrow = lead pipe sign of the distal transverse colon

• red arrow = thumbprinting of the proximal transverse colon.

The thumbprinting represents wall oedema and likely represents more acute (active) disease, with lead pipe appearance more distally representing chronic disease.

Thumb print and lead pipe sign suggests inflammation of the bowel.