Positive intraluminal bowel contrast on computed tomography following oral ingestion of kayexelate

Our study presents the computed tomography (CT) manifestations of orally ingested kayexelate (a powdered form of sodium polystyrene sulphonate) used to treat hyperkalemia. Five patients with whom kayexalate appeared as high-attenuating intraluminal enteric content, similar to oral contrast material or leakage of intravascular contrast, are reported. Radiologists should be familiar with its appearance as it may mimic oral or vascular contrast within the gastrointestinal tract, a finding that may lead to a diagnostic error or misinterpretation.