Non fatal barium intravasation during barium enema

Intravasation of barium sulphate at barium enema examination

We report a case of venous intravasation of barium sulphate occurring during a routine barium enema examination for investigation of rectal bleeding. The patient suffered a cardiopulmonary arrest, but made a full recovery after organ support in intensive care. Review of radiographs from the examination showed intravasated barium in pelvic vessels. We review the literature on this rare, but serious, complication of barium enema examination and suggest measures by which intravasation can be prevented.

Nonfatal barium intravasation into the portal venous system during barium enema examination

We report a case of barium intravasation in a 66-year-old patient. Unenhanced computed tomography (CT) scan revealed barium and air emboli in portal veins and liver. We believe he survived because his liver prevented inflow of barium into the systemic circulation. To the best of our knowledge, this is the 23rd reported case of venous barium intravasation in the last 50 years. Because all 23 patients had bowel disease or diverticulitis, we conclude barium enema should be used cautiously in such patients.