Provocative mesenteric angiography for diagnosis and treatment of occult gastrointestinal hemorrhage

Occult gastrointestinal (GI) hemorrhage can be a great challenge to both patients and physicians, exerting a great toll on patients and the healthcare system. While diagnostic capabilities for diagnosing GI bleeding are improving, particularly with the establishment of computed tomography angiography and capsule endoscopy as routine modalities, patients with intermittent massive GI bleeding continue to pose a diagnostic and management dilemma. In this review, the concept, efficacy, and safety of provocative mesenteric angiography is described. The body of literature suggests that this procedure is safe and effective in this patient population with little to no alternative options.