Pepto-Bismol Tablets Resembling Foreign Bodies on Abdominal Imaging

A 28-year-old female presented to the emergency department (ED) with a one-day history of severe, diffuse abdominal pain of sudden onset. In the ED, an abdominal x-ray was done, which showed two hyperdense disc-shaped structures. When her abdominal pain did not subside, the ED performed a computerized tomography (CT) scan of the abdomen and pelvis with contrast, which showed the two previously noted 16 mm disc-shaped objects to actually be located within the cecum. Based on the history and imaging, it was deduced that the two discs were likely to be Pepto-Bismol tablets (Proctor & Gamble Co., Cincinnati, OH). Most medications are radiolucent, but there are some that are radiopaque, including Pepto-Bismol (also known as bismuth subsalicylate). While quite a rare occurrence, it is important to know about since it can lead to unnecessary endoscopy and patient anxiety.