DÄ internationalArchive22-23/2020Clinical Snapshot Radiopaque Coproliths in the Pelvis Minor

Clinical Snapshot

Clinical Snapshot Radiopaque Coproliths in the Pelvis Minor

Dtsch Arztebl Int 2020; 117: 388. DOI: 10.3238/arztebl.2020.0388

Werner, C; Busch, M; Ritter, C

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A 56-year-old male dialysis patient was admitted for routine investigations in connection with kidney transplant listing. Pelvic radiography showed an inhomogeneously radiopaque structure projecting onto the pelvis minor and smaller concrements projecting onto the ascending, descending, and sigmoid colon (Figure). No contrast medium had been given. On specific questioning, the patient reported chronic obstipation since taking the phosphate binder lanthanum carbonate. Following administration of an enema, the structure projecting onto the rectum was no longer detectable. While obstipation is known to be a frequently occurring complication of treatment with lanthanum carbonate (1–10%), the radiopaque concrements, caused by the presence of the transition metal, represent a little-known radiological differential diagnosis of unclear radiopaque concrements of the gastrointestinal tract. Occasionally (0.1–1%) ileus is also found, in some cases from unchewed tablets.

Plain AP radiograph of the pelvis.
Figure
Plain AP radiograph of the pelvis.

Dr. med. Christoph Werner, Dr. med. Christopher Ritter, PD Dr. med. habil. Martin Busch
Klinik für Innere Medizin III, Universitätsklinikum Jena, martin.busch@med.uni-jena.de

Conflict of interest statement: The authors declare that no conflict of interest exists.

Translated from the original German by David Roseveare.

Cite this as: Werner C, Ritter C, Busch M: Radiopaque coproliths in the pelvis minor.
Dtsch Arztebl Int 2020; 117: 388. DOI: 10.3238/arztebl.2020.0388

Plain AP radiograph of the pelvis.
Figure
Plain AP radiograph of the pelvis.