Pancreatic imaging: sentinel loop and colon cut-off: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Radiology · Pancreatic imaging: sentinel loop and colon cut-off

Sample item

A patient with severe epigastric pain and raised lipase has a plain film showing a localised dilated jejunal loop in the left upper abdomen and an abrupt cut-off of gas at the splenic flexure. What are these signs?

ASentinel loop and colon cut-off sign of acute pancreatitisBRigler sign of pneumoperitoneumCCoffee bean and bird beak signs of sigmoid volvulusDThumbprinting of ischaemic colitis

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Sentinel loop and colon cut-off sign of acute pancreatitis

Local ileus near an inflamed pancreas dilates adjacent small bowel as a sentinel loop, and spasm of the transverse colon near the splenic flexure cuts off the gas column. Both are non-specific plain film signs of regional inflammation.

Option by option

A. Sentinel loop and colon cut-off sign of acute pancreatitis (correct)
Correct. These two plain film signs accompany acute pancreatitis.
B. Rigler sign of pneumoperitoneum
Rigler sign is gas on both sides of the bowel wall in pneumoperitoneum.
C. Coffee bean and bird beak signs of sigmoid volvulus
Coffee bean and bird beak describe volvulus.
D. Thumbprinting of ischaemic colitis
Thumbprinting is bowel wall oedema in ischaemic colitis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Sentinel loop and colon cut-off sign of acute pancreatitis. Local ileus near an inflamed pancreas dilates adjacent small bowel as a sentinel loop, and spasm of the transverse colon near the splenic flexure cuts off the gas column.

Why is "Rigler sign of pneumoperitoneum" not the answer?

Rigler sign is gas on both sides of the bowel wall in pneumoperitoneum.

Why is "Coffee bean and bird beak signs of sigmoid volvulus" not the answer?

Coffee bean and bird beak describe volvulus.

Why is "Thumbprinting of ischaemic colitis" not the answer?

Thumbprinting is bowel wall oedema in ischaemic colitis.

What concept does this question test?

It tests Pancreatic imaging: sentinel loop and colon cut-off in Radiology. Both are non-specific plain film signs of regional inflammation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pancreatic imaging: sentinel loop and colon cut-off?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.