A Fourth Cause of Bright Material in the Stomach on CT
Hyperdense gastric lesions on CT are usually drugs, oral contrast or blood, but this case points to a different explanation: a precipitate formed by bile and mannitol.
Bright material in the stomach on CT is usually read as ingested drugs, oral contrast, or blood. Mistaking drugs or contrast for active bleeding could lead to unnecessary interventions. This case report describes a rarer explanation.
A 25-year-old man with Crohn's disease underwent gastroscopy, which showed an antral ulcer, bile reflux, and a duodenal stricture. He then drank only a 2.5% mannitol solution to prepare for CT enterography. The scan showed several round, high-density lesions in the stomach, distinct from the gastric mucosa. He confirmed he had taken no medication.
To probe the cause, the team mixed artificial gastric juice, artificial bile, and 2.5% mannitol in a test tube, which produced a visible precipitate. They concluded the CT lesions most likely represent this precipitated material. This is a single case, and the explanation rests on an in vitro model rather than direct analysis of the lesions themselves.
Summary prepared with AI assistance from the published abstract and reviewed by a physician. Not medical advice. Learn more
