The colon cut-off sign is a radiographic finding seen on abdominal radiographs and computed tomography scans. It is characterized by a marked dilatation of the transverse colon, with an abrupt transition to collapsed distal colon, particularly the splenic flexure. [1] This sign is indicative of underlying pathology, most commonly acute pancreatitis.
The colon cut-off sign is due to local inflammation or irritation. In acute pancreatitis, the inflammatory process involving the pancreas and surrounding tissues can extend to the adjacent transverse colon through the phrenicocolic ligament. [2] This inflammation leads to spasm and localized ileus, causing a sharp demarcation between the dilated proximal bowel and the collapsed distal segment.
The colon cut-off sign is different from sentinel loop sign, where the dilated segment is a part of the small intestine.
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