The imaging of celiac disease and its complications—Review

      Celiac disease is a malabsorption syndrome in which dietary gluten damages the small bowel mucosa. Gluten contains gliadin, the primary toxic component that is primarily found in wheat, barley, and rye products. The initial diagnosis of coeliac disease is usually made by endoscopic biopsy of the jejunum, although sometimes imaging features can suggest the diagnosis. Once a diagnosis is made, patients need to be diet compliant and monitored for potential complications. Many complications are more common when dietary compliance is poor. Complications include intussusception (usually intermittent), ulcerative jejunitis, osteomalacia, cavitating lymph node syndrome, and an increased risk of malignancies such as lymphoma, adenocarcinoma, and squamous cell carcinoma. Radiological evaluation is central in the evaluation of these complications. Imaging may assist in both the diagnosis and staging of complications as well as in enabling radiologically guided percutaneous biopsy for complications of coeliac disease such as lymphoma. As celiac disease is a relatively common disorder; it is likely that most radiologists will encounter the disease and its potential complications. The aim of this review article was to discuss and illustrate the role of modern radiology in evaluating the many presentations of this complex disease.
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