Differentiating unexpected hyperattenuating intraluminal material from gastrointestinal bleeding on contrast enhanced dual-energy CT.

We present the case of a 24-year-old woman who presented to the emergency department with mid-epigastric pain and nausea. Contrast enhanced dual-energy CT showed high iodine signal in the small bowel lumen concerning for gastrointestinal bleeding since oral contrast was not given. However, overt bleeding symptoms were absent. Further in-house analysis of the dual-energy CT data revealed the hyperattenuating intraluminal material to be oral indigestion medicine containing magnesium, aluminum, or bismuth, and not extravasated iodine.