GI imaging: ischaemic colitis: 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 · GI imaging: ischaemic colitis

Sample item

A 72-year-old woman with atrial fibrillation has sudden left-sided abdominal pain and bloody diarrhoea. A plain film shows thumbprinting of the descending colon. Which segment is typically most vulnerable to this condition?

AThe rectum onlyBThe transverse duodenumCThe splenic flexure, a watershed areaDThe caecum

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

The answer and the reasoning

C. The splenic flexure, a watershed area

Ischaemic colitis favours the splenic flexure and rectosigmoid junction, which are watershed zones between the superior and inferior mesenteric arterial supplies. Wall oedema and submucosal haemorrhage produce thumbprinting. The rectum is spared in many cases because of its dual supply.

Option by option

A. The rectum only
The rectum is relatively protected by its dual blood supply.
B. The transverse duodenum
The duodenum is not part of the colon.
C. The splenic flexure, a watershed area (correct)
Correct. The splenic flexure is a classic watershed site.
D. The caecum
The caecum is involved in right-sided ischaemia, which is less common and often linked to arterial occlusion.

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 C, The splenic flexure, a watershed area. Ischaemic colitis favours the splenic flexure and rectosigmoid junction, which are watershed zones between the superior and inferior mesenteric arterial supplies.

Why is "The rectum only" not the answer?

The rectum is relatively protected by its dual blood supply.

Why is "The transverse duodenum" not the answer?

The duodenum is not part of the colon.

Why is "The caecum" not the answer?

The caecum is involved in right-sided ischaemia, which is less common and often linked to arterial occlusion.

What concept does this question test?

It tests GI imaging: ischaemic colitis in Radiology. Wall oedema and submucosal haemorrhage produce thumbprinting. The rectum is spared in many cases because of its dual supply.

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 GI imaging: ischaemic colitis?

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.