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Updated: Jul 19, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Angiographic diagnosis of inflammatory bowel disease in patients presenting with gastrointestinal bleeding
Alex M Barnacle1, Anthony C B Aylwin, James E Jackson
1Department of Imaging, Great Ormond St. Hospital for Children, London, United Kingdom.
Insights
Visceral angiography can identify inflammatory bowel disease (IBD) in approximately 5% of patients with gastrointestinal bleeding. Radiologists should consider IBD even with normal prior investigations.
Area of Science:
- Gastroenterology
- Diagnostic Imaging
- Radiology
Background:
- Gastrointestinal bleeding is a common clinical problem requiring accurate diagnosis.
- Inflammatory bowel disease (IBD) can present with gastrointestinal bleeding, but diagnosis can be challenging.
- Visceral angiography is a diagnostic tool used to investigate gastrointestinal hemorrhage.
Purpose of the Study:
- To review the final diagnosis and outcomes in patients undergoing visceral angiography for gastrointestinal hemorrhage.
- To assess the utility of visceral angiography in diagnosing inflammatory bowel disease (IBD) based on angiographic findings.
- To determine the prevalence of IBD in patients with suspected gastrointestinal bleeding investigated by visceral angiography.
Main Methods:
- Retrospective review of visceral angiography referrals over a 10-year period.
- Analysis of 522 visceral angiograms performed for gastrointestinal bleeding.
- Identification of patients with suspected or probable IBD based on angiographic findings.
Main Results:
- Inflammatory bowel disease (IBD) was confirmed in 25 (58%) of 43 patients with suspected IBD on angiography.
- IBD represented 4.8% of all patients referred for gastrointestinal bleeding investigation.
- In 14 individuals, IBD was not previously suspected; a non-IBD diagnosis was found in seven subjects.
Conclusions:
- Inflammatory bowel disease (IBD) is an expected cause in approximately 5% of patients with gastrointestinal bleeding investigated by angiography.
- Radiologists should recognize angiographic abnormalities associated with IBD.
- Consideration of IBD is important, even if previous investigations were normal.
Objective:
The objective of our study was to review the final diagnosis and outcome in patients undergoing visceral angiography for gastrointestinal hemorrhage in whom a diagnosis of inflammatory bowel disease (IBD) had been suspected on the basis of angiographic findings.
Materials And Methods:
A retrospective review was performed of all visceral angiography referrals over a 10-year period. During that time, 522 visceral angiograms were obtained for the investigation of acute or chronic gastrointestinal bleeding. IBD was reported as a possible or probable diagnosis based on the angiographic findings in 43 patients (8.2%) (male-to-female ratio, 23:20; age range, 11-79 years; mean age, 48.6 years).
Results:
Active IBD was confirmed in 25 (58%) of these 43 individuals (male-to-female ratio, 15:10; mean age, 46.5 years), representing 4.8% of all patients referred for the investigation of gastrointestinal bleeding. In 14 of these individuals, a diagnosis of IBD had not been suspected previously. A diagnosis other than IBD was found to be the cause of the angiographic findings in seven subjects. In the 32 patients in whom a cause for the angiographic findings was identified, IBD was the diagnosis in 25 (78%).
Conclusion:
In a group of patients referred for angiography to investigate acute or chronic gastrointestinal bleeding, IBD can be expected to be the cause in approximately 5%. Radiologists should be aware of the angiographic abnormalities seen in patients with IBD and be prepared to consider this diagnosis even if the results of other previous investigations have been reported as normal.
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