Proper management for morbid iatrogenic retroperitoneal barium insufflation

Perforation of barium sulfate enterography in an infant: A case report

RATIONALE

Barium peritonitis is an inflammatory response that occurs when barium accidentally enters the abdominal cavity during a barium test. In extreme circumstances, it has the potential to harm various organs and even result in death.

PATIENT CONCERNS

A 3-month-old infant was diagnosed with multiple organ failure after severe barium peritonitis.

DIAGNOSIS

Multiple organ dysfunction is associated with barium peritonitis.

INTERVENTIONS

The infant underwent surgical intervention and received ventilator support, anti-infection therapy, myocardial nutrition, liver and kidney protection, rehydration, circulation stabilization, and other symptomatic supportive care.

OUTCOMES

The patient experienced clinical death after treatment and resuscitation was unsuccessful.

LESSONS

Barium enema perforation complications are uncommon, but can lead to fatal injuries with a high mortality rate. This case highlights the importance of raising awareness among clinicians about the risks of gastroenterography in infants and children and actively preventing and avoiding similar serious complications. The mortality rate can be reduced by timely multidisciplinary consultation and joint management once a perforation occurs.

Barium Retention Following Examination for Pylorus Stenosis

Barium retention is a rare complication of upper gastrointestinal tract examination when using barium sulphate as a contrast agent. We present a case of rare barium retention and precipitation in the stomach in terrain of chronic gastrostasis and the review of literature on complications of barium sulphate administration. A 38-year-old patient was diagnosed with benign pylorostenosis. After consulting radiology department barium contrast-enhanced X-ray has been indicated. The diagnostic process and the resulting treatment of the complications are described. Patient’s informed consent was obtained. The use of barium sulphate as a contrast agent led to stasis and impaction of the contrast agent, which led to emergency surgery. Histology proved malignant stenosis of the pylorus. The resection edges proved insufficient and a repeated resection was performed. At the time of submission the patient has no confirmed metastatic lesions. In cases of suspected gastrostasis and serious stenosis of the intestine, use of barium sulphate should be avoided and iodine-based contrast agents should be used instead.