The imaging of coeliac disease and its complications

Eur J Radiol. 2008 Mar;65(3):483-90. doi: 10.1016/j.ejrad.2007.04.015. Epub 2007 May 24.


Coeliac 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 both in the diagnosis and staging of complications as well as enabling radiological guided percutaneous biopsy for complications of coeliac disease such as lymphoma. As coeliac 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 is to discuss and illustrate the role of modern radiology in evaluating the many presentations of this complex disease.

Publication types

  • Review

MeSH terms

  • Barium Sulfate
  • Celiac Disease / complications*
  • Celiac Disease / diagnostic imaging*
  • Contrast Media
  • Humans
  • Ileitis / diagnostic imaging
  • Ileitis / etiology
  • Intestinal Neoplasms / diagnostic imaging
  • Intestinal Neoplasms / etiology
  • Intussusception / diagnostic imaging
  • Intussusception / etiology
  • Lymphoma / diagnostic imaging
  • Lymphoma / etiology
  • Tomography, X-Ray Computed


  • Contrast Media
  • Barium Sulfate