Which condition is characterized by a "string of pearls" appearance on imaging?

The "string of pearls" appearance on imaging is indicative of small bowel obstruction. This specific radiological finding occurs due to the presence of multiple air-fluid levels within the dilated loops of bowel, which resemble a string of pearls. In cases of small bowel obstruction, the proximal segments become distended as they cannot effectively pass their contents beyond the obstructed segment, leading to the characteristic stacking of air-fluid levels that can be seen on X-rays or CT scans.

In contrast, colon perforation generally presents with free air under the diaphragm on upright films or can show signs of peritonitis, while appendicitis typically presents with localized signs and tenderness in the right lower quadrant and may show an enlarged appendix on imaging. Diverticulitis often reveals localized inflammation or abscess formation near diverticula rather than the distinct "string of pearls" pattern seen in small bowel obstruction. Understanding these imaging characteristics is critical in diagnosing and managing abdominal conditions.