METASTATIC SEEDING ALONG THE SMALL BOWEL MESENTERY ROENTGEN FEATURES

1. Intra-abdominal malignant seeding along the small bowel mesentery is roentgenologically identifiable.

2. The anatomic features of the small bowel mesentery and the pathways of flow of ascitic fluid along its peritoneal recesses determine the deposition and growth of seeded metastases.

3. Seeded deposits lodge particularly within the lower recesses of the small bowel mesentery and are reflected by typical changes involving distal ileal loops or the cecum.

4. These are characterized by (a) palisading, arcuate scalloped deflections or gross mass displacement of distal small bowel loops in the right lower quadrant, or (b) extrinsic indentations upon the medial and inferior contours of the cecum. Associated desmoplastic reaction may result in tethering of mucosal folds and angulated fixation of bowel loops.

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