A 70-year-old man with chronic constipation undergoes double-contrast barium enema. The colon is shortened with loss of haustrations, giving a rigid, featureless, pipe-stem appearance extending from the rectum proximally in a continuous fashion. This finding is most characteristic of:

• A Crohn disease
• B Colonic adenocarcinoma
• C Chronic ulcerative colitis ✓
• D Ischemic colitis

Explanation

Chronic ulcerative colitis produces a shortened, rigid, featureless colon with loss of haustrations extending continuously from the rectum proximally (the 'pipe stem' colon). Crohn disease is segmental and skip lesions. Adenocarcinoma causes focal mass or stricture. Ischemic colitis is segmental and thumbprinting may be seen acutely. The continuous involvement from the rectum is the key discriminating feature.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.