Starry-sky bowels

Purpose: Because of the increasing usage of lanthanum carbonate in dialysis patients, clinicians should be aware of its typical radiographic appearance. Methods: A dialysis patient received a plain film and a computed tomography, both showing a “starry-sky” appearance in the nearly whole colon, and the radiological report mistakenly denoted it as barium. Results: The patient denied any exposure to barium or radiocontrast medium. Tracing back her medication history, lanthanum carbonate, 500 mg twice a day, has been prescribed for her hyperphosphatemia in recent 5 months. Conclusions: Clinicians should be aware of typical radiographic appearance of lanthanum carbonate to avoid unnecessary management and may also take its radiopaque characteristic as an advantage to assess the patient's drug adherence.