Intestinal metastases from gastric adenocarcinoma: Helical CT findings

Purpose: The purpose of this work was to describe the helical CT findings of intestinal metastasis from gastric adenocarcinoma. Method: Twenty-three patients with intestinal metastasis from gastric adenocarcinoma found at helical CT were included. CT findings and clinical and pathologic data were reviewed. Results: The most common characteristic finding was target-like concentric bowel wall thickening (thick inner high-outer low, n = 18) involving multiple long segments with progressive thickening of the enhancing inner layer. Fifteen cases (65%) involved multiple sites, and the ascending colon (n = 12) and rectum (n = 11) were the two most common sites. Peritoneal carcinomatosis (n = 15, 65%) and bowel obstruction (n = 14, 61%) were common associated findings. Regarding the primary lesion, the majority was linitis plastica (n = 16) and poorly differentiated adenocarcinoma with or without signet-ring cell differentiation (n = 14). Conclusion: Intestinal metastasis from gastric adenocarcinoma, especially of the linitis plastica type, most commonly showed target-like long segmental wall thickening with a characteristically thick inner enhancing layer on helical CT.