Differential Diagnosis for Ingested Opacities on CT of the Abdomen and Pelvis

Single Most Likely Diagnosis

• Ingested medication or supplements (e.g., iron, calcium, or vitamin supplements): This is the most common cause of ingested opacities seen on CT scans, as many medications and supplements contain dense materials that are visible on radiographs.

Other Likely Diagnoses

• Ingested foreign bodies (e.g., coins, batteries, or other small objects): These can appear as opacities on CT scans, especially if they are made of dense materials like metal.
• Food items with high density (e.g., popcorn kernels or pits from fruits): Certain types of food can appear opaque on CT scans due to their density.

Do Not Miss Diagnoses

• Ingested toxic substances (e.g., lead or mercury): Although less common, ingesting toxic substances can be life-threatening and must be considered in the differential diagnosis to ensure prompt treatment.
• Button battery ingestion: Button batteries can cause severe burns to the esophageal or gastrointestinal mucosa and require immediate medical attention.

Rare Diagnoses

• Ingested packets of illicit drugs: In rare cases, individuals may ingest packets of drugs, which can appear as opacities on CT scans.
• Ingested sharp objects: While less common, ingesting sharp objects can lead to serious complications, including perforation of the gastrointestinal tract.
• Pica with ingestion of non-food items (e.g., dirt, clay, or chalk): Pica is a condition characterized by eating non-food items, which can sometimes appear as opacities on imaging studies.