title: Medications as causes of intraluminal hyperdensities: what radiologists need to know.
abstract: In computed tomography (CT) angiogram or some dedicated CT studies of the abdomen, the use of positive enteric contrast should be avoided as its presence could decrease the sensitivity of the test. There are, however, cases of CT scans with unexpected hyperdense intraluminal contents detected due to the use of certain oral or rectal medications. Reports on medications as causes of intraluminal hyperdensities are sparse in the English literature. We have studied several commonly used medications and revealed that many drugs appear hyperdense in CT scans. The presence of unexpected intraluminal hyperdensities can potentially cause erroneous interpretation of images and in some cases decrease the sensitivity of the test. The hyperdense bowel contents may be mistaken as acute hemorrhage in CT angiogram for detection of GI bleeding. Active GI bleeding, presented as intraluminal extravasation of contrast material, can also be obscured. Certain intra-abdominal pathologies could be masked, for example, in plain CT scan for detection of urinary tract stones or in contrast CT study for suspected bowel ischaemia. It is important for radiologists and clinicians to be aware of this situation in order to prevent misinterpretation of images and to select the most appropriate imaging modality when such unexpected intraluminal hyperdensities are encountered.
authors: Department of Radiology, HLG 1, Main Block, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong. fnysin@yahoo.com.hk
authors: Francesca Nga Yee
authors: FN
authors: Sin
authors: Jane Pui Ki
authors: JP
authors: Tsang
authors: Kwong Lok
authors: KL
authors: Siu
authors: Johnny Ka Fai
authors: JK
authors: Ma
authors: Alfred Wei Tak
authors: AW
authors: Yung
mesh_terms: D000536:Aluminum Hydroxide / Q000008:administration & dosage; D000638:Amiodarone / Q000008:administration & dosage; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage; D000792:Angiography; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D002119:Calcium Carbonate / Q000008:administration & dosage; D003287:Contrast Media / Q000008:administration & dosage; D003408:Cresols / Q000008:administration & dosage; D003951:Diagnostic Errors; D003992:Dibucaine / Q000008:administration & dosage; D004338:Drug Combinations; D005990:Glycerol / Q000008:administration & dosage; D006801:Humans; D007454:Iodides / Q000008:administration & dosage; D058085:Iron Compounds / Q000008:administration & dosage; D019047:Phantoms, Imaging; D011137:Polystyrenes / Q000008:administration & dosage; D011189:Potassium Chloride / Q000008:administration & dosage; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed
chemical_list: D000893:Anti-Inflammatory Agents; D003287:Contrast Media; D003408:Cresols; D004338:Drug Combinations; C012315:Factu; D007454:Iodides; D058085:Iron Compounds; D011137:Polystyrenes; D000536:Aluminum Hydroxide; D011189:Potassium Chloride; C003321:polystyrene sulfonic acid; D019980:Amoxicillin-Potassium Clavulanate Combination; D002119:Calcium Carbonate; D003992:Dibucaine; D000638:Amiodarone; D005990:Glycerol; C010389:Lugol's solution