Diffuse Separation of loops (without tethering)

Extrinsic process

• Mucosal sparing

• Radiographic Signs of Extrinsic Process

•           Mass effect - constant or inconstant

•           Luminal constriction (with intact mucosa)

•           Fixation and angulation of bowel loops

•           Fixation and angulation of folds

•            “Traction change”

•            “Transverse stretch”

• Signs of advanced disease

•           Obstruction

•           Wall invasion with ulceration

•           Fistula

• Examples

•           Hypertrophied mesenteric fat

•           Ascites

•           Mesenteric or retroperitoneal lymphadenopathy

•            Lymphoma

•            Whipples’s disease

•            AIDS-related

•            Pimary mesenteric tumors

Spontaneous mesenteric hematoma causing separation of loops.  Arrows (above) and “H” (below) delineate the extrinsic mass.