In a barium enema, the 'apple-core' deformity is MOST characteristic of which colonic pathology?
- A Ulcerative colitis
- B Diverticulitis with stricture
- C Carcinoma of the colon ✓
- D Crohn's colitis
Correct answer: C. Carcinoma of the colon
Explanation
The apple-core (or 'napkin-ring') deformity on barium enema represents an annular constricting carcinoma of the colon with abrupt shouldered ('shelf-like') margins, mucosal destruction, and luminal narrowing. This is the classic appearance of colonic adenocarcinoma. Diverticular disease produces a longer, more gradual stricture with preserved folds. Ulcerative colitis shows tubular narrowing with loss of haustra but not abrupt shelving. Crohn's disease shows segmental 'string sign' strictures.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
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