Bone in the belly: traumatic heterotopic mesenteric ossification

Heterotopic mesenteric ossification is an unusual but important complication in patients who sustain blunt and penetrating abdominal trauma. In this condition, bone formation occurs in the mesenteric and omental fat in response to injury and may result in serious complications such as bowel obstruction and fistula formation. Although a few case reports exist, the radiology literature on this topic is scant. Based on our experience, this entity is under-recognized on imaging studies and often results in diagnostic confusion due to its resemblance to other pathologies such as barium leak and extraskeletal bone-forming neoplasms. This review highlights the imaging features of heterotopic mesenteric ossification with an emphasis on computed tomographic findings. Radiologist awareness of this condition is crucial to avoid misdiagnosis as well as to direct appropriate and timely management.