String sign of Kantor

摘要

Thin stripe of barium resembling a frayed cotton string seen on barium small bowel studies, at a site of lumen narrowing, is known as gastrointestinal string sign or string sign of Kantor (Figs. 1, 2) [1] The string sign indicates marked narrowing of the bowel lumen of any etiology, but is classically associated with Crohn disease. This sign was described first in a series of six patients with terminal ileitis by Kantor [2]. The string sign may be seen in stenotic as well as non-stenotic phases of Crohn's disease, due to irritability and spasm initially and, fibrosis later [1]. Any portion of the bowel may demonstrate this sign, though it is classically described in the terminal ileum. This finding has also been extrapolated to CT scans done following luminal contrast (Fig. 3) [3]. Other diseases in which string sign is described include hypertrophic pyloric stenosis, gastrointestinal tuberculosis, carcinoid tumor, and carcinoma [1, 3, 4].