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Updated: Jul 19, 2025

Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Provocative mesenteric angiography for occult gastrointestinal bleeding: a systematic review
Siddhi Hegde1, Patrick D Sutphin2, Omar Zurkiya2
1Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. siddhi.hegde5@gmail.com.
Abstract:
Occult gastrointestinal bleeding (GIB) is a challenge for physicians to diagnose and treat. A systematic literature search of the PubMed and Embase databases was conducted up to January 1, 2023. Eligible studies included primary research studies with patients undergoing provocative mesenteric angiography (PMA) for diagnosis or localization of occult GIB. Twenty-seven articles (230 patients) were included in the review. Most patients (64.8%) presented with lower GIB. The average positivity rate for provocative angiography was 48.7% (58% with heparin and 46.7% in thrombolytics). Embolization was performed in 46.4% of patients, and surgical management was performed in 37.5%. Complications were rare. PMA can be an important diagnostic and treatment tool but studies with high-level evidence and standardized protocols are needed to establish its safety and optimal use.
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