J Korean Soc Radiol.  2017 Jun;76(6):425-428. 10.3348/jksr.2017.76.6.425.

Barium Peritonitis Following Upper Gastrointestinal Series: A Case Report

• Ko S
• Hwang J
• Kim YJ
• Hong SS

• KMID: 2379325
• DOI: http://doi.org/10.3348/jksr.2017.76.6.425

Abstract

We report a rare case of barium peritonitis following an upper gastrointestinal (GI) series and its imaging findings in a 74-year-old female. Barium peritonitis is a rare but life-threatening complication of GI contrast investigation. Therefore, clinical awareness of barium peritonitis as a complication of GI tract contrast investigation would help to prevent such a complication and manage the patients properly.

MeSH Terms

Aged
Barium Sulfate
Barium*
Female
Gastrointestinal Tract
Humans
Intestinal Perforation
Peritonitis*
Upper Gastrointestinal Tract
Barium
Barium Sulfate

Figure

• 

  Fig. 1 Pre- and post-operative images of barium peritonitis following an upper gastrointestinal series in a 74-year-old female. A. Pre-operative plain abdominal radiography shows extensive barium spillage in the peritoneal cavity with pneumoperitoneum. Especially, larger amounts of agglomerated barium clumps are seen in bilateral subdiaphragmatic areas (arrows). B. Pre-operative unenhanced axial CT image reveals agglomerated barium clumps adhering to the parietal and visceral surfaces of the peritoneal cavity with a large volume of pneumoperitoneum. Assessment of bowel perforation on current CT images is limited due to unenhanced scan protocol, insufficient bowel distension and beam hardening artifacts. C. Post-operative plain abdominal radiography on the 3rd post-operative day shows residual barium, which outlines the abdominopelvic cavity and probably adheres along the peritoneum. D. Contrast-enhanced axial CT image on the 19th post-operative day shows residual barium and mesenteric fat haziness with ascites. Generalized soft tissue edema is also seen.

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