In TB the normal ilecaecal angle is lost with the dilated terminal ileum appearing suspended from a pulled up and contracted caecum giving rise to Gooseneck deformity (Figure 7). The caecum is shrunken, and is distorted resulting in a conical caecum which is pulled out of the iliac fossa as a result of fibrosis. Stierlin’s sign is a manifestation of acute inflammation superimposed on a chronically involved segment of bowel. The inflamed segments of ileum, caecum and ascending colon are characterised by lack of barium column with a normal configured column of barium on either side. It appears as narrowing of the terminal ileum with rapid emptying into a shortened, obliterated and rigid caecum. String sign denotes a persistent narrow stream of barium indicating stenosis. Localised stenosis opposite ileocaecal valve with a smooth rounded off caecum and dilated terminal ileum results in purse string stenosis.
Both Gooseneck sign and Stierlin’s sign can be seen in Gastrointestinal Tuberculosis.Thank you.