Abdominal and GI imaging: Stierlin sign: 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.

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Radiology · Abdominal and GI imaging: Stierlin sign

Sample item

A barium follow-through in a patient with suspected ileocaecal tuberculosis shows rapid emptying of an inflamed terminal ileum and caecum, with barium running from the ileum into the ascending colon without filling the shrunken caecum. What is this sign called?

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

The answer and the reasoning

D. Stierlin sign

In ileocaecal tuberculosis the inflamed, irritable terminal ileum and caecum empty rapidly and the caecum fails to hold barium, giving the Stierlin sign. The Fleischner sign is a gaping ileocaecal valve with a narrowed terminal ileum. Crohn disease more typically gives a string sign.

Option by option

  • A. Thumbprinting

    Thumbprinting is bowel wall oedema in ischaemic colitis.

  • B. Lead pipe colon

    Lead pipe colon is a featureless colon of chronic ulcerative colitis.

  • C. String sign of Kantor

    The string sign is a persistently narrowed segment of ileum in Crohn disease.

  • D. Stierlin sign (correct)

    Correct. Rapid emptying with a non-filling contracted caecum is Stierlin sign.

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.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Stierlin sign. In ileocaecal tuberculosis the inflamed, irritable terminal ileum and caecum empty rapidly and the caecum fails to hold barium, giving the Stierlin sign.

Why is "Thumbprinting" not the answer?

Thumbprinting is bowel wall oedema in ischaemic colitis.

Why is "Lead pipe colon" not the answer?

Lead pipe colon is a featureless colon of chronic ulcerative colitis.

Why is "String sign of Kantor" not the answer?

The string sign is a persistently narrowed segment of ileum in Crohn disease.

What concept does this question test?

It tests Abdominal and GI imaging: Stierlin sign in Radiology. The Fleischner sign is a gaping ileocaecal valve with a narrowed terminal ileum. Crohn disease more typically gives a string sign.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Abdominal and GI imaging: Stierlin sign?

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.