In pancreatitis, colon cutoff sign is seen at which part of the colon?

• A. Splenic flexure
• B. Hepatic flexure
• C. Cecum
• D. Sigmoid

Answer: (A)

Colon cutoff sign arises when acute pancreatitis irritates the left side of the colon near the splenic flexure, causing reflex spasm. On a plain abdominal radiograph, gas in the colon abruptly terminates at the splenic (left) flexure with little or no gas beyond it. This localization makes the splenic flexure the classic site for the cutoff sign because the tail of the pancreas sits adjacent to this area. The other flexures (hepatic) or sections like the cecum or sigmoid are not the typical locations for this radiographic finding.