Thirty-two patients with jejunal patches in the oral cavity and oropharynx were examined with contrast-enhanced computed tomography (CT). The morphology of the intestinal wall, the mesenteric fatty tissue, mesenteric lymph nodes and the region of the anastomosis were evaluated and correlated with clinical findings. The size and number of mesenterial lymph nodes, which were found in 16 cases, did not correlate with tumour recurrence. The benign alterations of the intestinal wall ranged from flat surfaces with no enhancement to significant enhancement with persisting folds. In cases with persisting intestinal folds, separation of tumour recurrence was achieved by identification of a typical double-layer configuration of the enhancing mucosa, and the restriction of alterations to the intestinal wall compartment. Tumour recurrences occurred at patch margins and were reliably distinguished from normal patches. For differentiation of findings, an exact localization of jejunum-patch compartments and margins with contrast-enhanced CT was, therefore, necessary.