Question
Hose pipe appearance of intestine is a feature of
| A. |
Crohn’s disease |
| B. |
Malabsorption syndrome |
| C. |
Ulcerative colitis |
| D. |
Hirschsprung disease |
|
Correct Answer » C Explanation |
 |
Detailed Explanation:
Clinical Reasoning for the Correct Answer:
– The “hose pipe appearance” describes a loss of haustration leading to a smooth, featureless colon.
– This is classic for chronic ulcerative colitis, where chronic inflammation and healing lead to rigid, atonic colonic segments lacking normal haustra.
Why Option A is Incorrect (Crohn’s disease):
– Crohn’s disease shows skip lesions, transmural inflammation, and may produce “string sign” (narrowed, stiff segments), not the uniform loss of haustra.
– Imaging more commonly shows cobblestoning, strictures, or fistulas.
– Crohn’s often affects small intestine and colon in a discontinuous pattern.
Why Option B is Incorrect (Malabsorption syndrome):
– Malabsorption does not have a specific pathognomonic radiologic intestinal appearance.
– It may show generalized bowel dilation, but not the classic “hose pipe” (featureless colon) seen in ulcerative colitis.
Why Option D is Incorrect (Hirschsprung disease):
– Hirschsprung disease is a congenital disorder manifesting with dilated proximal colon with a narrow distal aganglionic segment (“transition zone”).
– No “hose pipe” appearance; radiologic hallmark is a sharply demarcated area between normal and affected bowel.
—
High‑Yield Synopsis: Ulcerative Colitis
– Etiology & Pathogenesis
– Chronic inflammatory disease of colon; unknown etiology (immune-mediated).
– Starts in rectum, progresses proximally in continuous fashion.
– Clinical Features
– Bloody diarrhea, abdominal pain, urgency, tenesmus.
– Chronic course with relapses and remissions.
– Differential Diagnoses
– Crohn’s disease: Skip lesions, transmural inflammation, perianal involvement.
– Infectious colitis: Acute onset, positive stool cultures.
– Ischemic colitis: Older patients, sudden pain, segmental involvement.
– Diagnostic Findings
– Colonoscopy: Continuous mucosal inflammation, lost vascular pattern, friable mucosa.
– Imaging (barium enema): “Lead pipe” or “hose pipe” appearance due to loss of haustra.
– Labs: Anemia, elevated ESR/CRP in active disease.
– Management & Prognosis
– Medications: 5-aminosalicylic acid derivatives, corticosteroids for flares, immunomodulators.
– Surgery (colectomy): Curative for disease but reserved for refractory or complicated cases.
– Increased risk of colorectal cancer; requires long-term surveillance.
