The 'string sign' on barium meal examination of the duodenum, showing a thin stream of contrast through a narrowed cap, is associated with:

• A Duodenal carcinoma
• B Chronic duodenal ulcer with fibrosis and scarring ✓
• C Annular pancreas compressing the duodenum
• D Superior mesenteric artery syndrome

Explanation

The 'string sign' in the duodenal bulb on barium examination indicates severe narrowing of the pyloric channel or duodenal cap secondary to fibrosis from chronic peptic ulcer disease. The residual narrowed lumen allows only a thin barium stream. Annular pancreas produces an extrinsic impression on the second part of the duodenum with a 'double bubble' sign. SMA syndrome compresses the third part of the duodenum. Duodenal carcinoma shows an irregular filling defect, not a string sign.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.