GI imaging: sigmoid volvulus: 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 · GI imaging: sigmoid volvulus

Sample item

A bedridden elderly patient has abdominal distension and constipation, and a radiograph shows a hugely dilated gas-filled loop rising from the pelvis toward the right upper quadrant with an inverted U shape and a central line. What is the sign?

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

The answer and the reasoning

A. Coffee bean sign of sigmoid volvulus

A twisted sigmoid forms a closed loop whose walls oppose each other, making a coffee bean appearance with the crease pointing toward the left lower quadrant. A contrast enema shows a bird's beak at the twist. Sigmoidoscopic decompression is the initial treatment.

Option by option

  • A. Coffee bean sign of sigmoid volvulus (correct)

    Correct. An inverted U-shaped dilated loop with a central crease is the coffee bean sign.

  • B. Thumbprinting

    Thumbprinting is bowel wall oedema in ischaemia or colitis.

  • C. Apple core sign

    Apple core is the annular narrowing of a colorectal carcinoma on enema.

  • D. Lead pipe colon

    Lead pipe colon indicates chronic ulcerative 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.

More Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Coffee bean sign of sigmoid volvulus. A twisted sigmoid forms a closed loop whose walls oppose each other, making a coffee bean appearance with the crease pointing toward the left lower quadrant.

Why is "Thumbprinting" not the answer?

Thumbprinting is bowel wall oedema in ischaemia or colitis.

Why is "Apple core sign" not the answer?

Apple core is the annular narrowing of a colorectal carcinoma on enema.

Why is "Lead pipe colon" not the answer?

Lead pipe colon indicates chronic ulcerative colitis.

What concept does this question test?

It tests GI imaging: sigmoid volvulus in Radiology. A contrast enema shows a bird's beak at the twist. Sigmoidoscopic decompression is the initial treatment.

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: sigmoid volvulus?

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.