The Association Between Barium Examination and Subsequent Appendicitis: A Nationwide Population-Based Study

Li, Haoming; Yeh, Lee‐Ren; Huang, Yajing; Lin, Cheng‐Li; Kao, Chia‐Hung

doi:10.1016/j.amjmed.2016.07.017

Cited by 8 publications

(6 citation statements)

References 28 publications

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“…Barium appendicitis is a rare complication of barium swallow in children. Some authors have suggested that barium studies are associated with an increased, time-dependent appendicitis risk ( 6 ). Barium appendicitis is defined as follows: (1) a history of a prior barium examination; (2) diagnosed with acute appendicitis; and (3) CT scan shows a high-density substance in the appendiceal lumen.…”

Section: Discussionmentioning

confidence: 99%

Barium Appendicitis 6 Weeks After Upper Gastrointestinal Imaging

Shen

Sun

2020

Front. Pediatr.

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Barium sulfate is widely used for gastroenterology imaging. Retention of barium in the appendix, where it acts as an appendicolith, thereby leading to obstruction and inflammation. Barium-associated appendicitis is a very rare complication of upper gastrointestinal imaging (UGI), especially in children. We present a case involving an 8-year-old girl who was diagnosed with acute appendicitis due to a barolith and required a laparoscopic appendectomy 6 weeks after UGI. After UGI, patients should be informed regarding possible retention of barium in the appendix, which can cause acute appendicitis. Then, a laparoscopic appendectomy was performed successfully. We should be cautious of this potential risk to prevent complications with early intervention in children.

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Section: Discussionmentioning

confidence: 99%

Barium Appendicitis 6 Weeks After Upper Gastrointestinal Imaging

Shen

Sun

2020

Front. Pediatr.

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“…In particular, a history of gastrointestinal examination using barium is important. Li et al reported that barium examination of the gastrointestinal tract has a time-dependent association with appendicitis risk [7]. …”

Section: Discussionmentioning

confidence: 99%

Delayed Awareness of the History of Barium Examination: Perforated Barium Appendicitis

Saigusa¹,

Ohi

Oki

et al. 2017

Case Reports in Gastrointestinal Medicine

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A 41-year-old man presented to our hospital with lower abdominal pain and a high-grade fever. Physical examination revealed rebound tenderness and guarding in the lower abdomen. Abdominal X-ray examination showed a radiopaque object in the right lower quadrant of the abdomen. Abdominal computed tomography (CT) demonstrated that the object had a strong artifact with over 10,000 Hounsfield units, as well as ascites around the terminal ileum. We diagnosed acute peritonitis with a suspicion of the perforation due to unknown foreign body and performed an emergency laparotomy. Operative findings showed a contained perforation of a phlegmonous appendicitis, and appendectomy was performed. The resected specimen demonstrated that the appendix contained a fecalith, and histopathological examination showed the crystal structure of barium sulfate in the lumen of the appendix. Unfortunately, we did not obtain the history of screening for gastric cancer using a barium examination one month prior to our appendectomy. Our experience demonstrates the importance of establishing a history of barium examinations of the gastrointestinal tract in a patient with a radiopaque object in the right lower quadrant of the abdomen for early diagnosis of barium appendicitis. Additionally, early diagnosis of barium appendicitis may affect the selection of surgical procedures.

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“…Moreover, Li, et al [ 6 ] performed a nationwide study in Taiwan, where they found a 1.19 incidence rate of appendicitis in patients who underwent a barium study. Additionally, they concluded that there is an increased, time-dependent risk of appendicitis in patients who undergo a barium study.…”

Section: Discussionmentioning

confidence: 99%

A Barium Swallow Study Leading to an Incidental Finding on a Screening Colonoscopy

Rojas¹,

Orabi²,

Speth

2017

Cureus

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Barolith is a mixture of firm feces with barium sulfate, and a frequent cause of obstruction of the appendiceal lumen that can result in appendicitis. Nonetheless, some other complications like aspiration, allergic reaction, and bowel obstruction have also been reported. We present the case of a 71-year-old man with a history of amyotrophic lateral sclerosis (ALS), who came to the gastroenterology clinic complaining of intermittent loose stools and dysphagia to solids for the past months. The patient underwent a barium swallow study six days prior and was completely normal. A colonoscopy was done showing normal appearing mucosa, with a whitish foreign object found on the appendiceal orifice. Removal of the barolith was done by means of a biopsy forceps.Our patient did not have any signs or symptoms of appendicitis prior to the procedure, and the successful removal of the barolith was achieved. Elderly patients, and patients with decreased gastrointestinal (GI) transit, could be a population at risk for barium retention/appendicitis; for this reason, more research studies should be done to assess possible preventive treatments.

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The Association Between Barium Examination and Subsequent Appendicitis: A Nationwide Population-Based Study

Abstract: BE was associated with an increased, time-dependent appendicitis risk. Clinicians should be aware of this potential risk to avoid delayed diagnoses.

Cited by 8 publications

References 28 publications

Barium Appendicitis 6 Weeks After Upper Gastrointestinal Imaging

Barium Appendicitis 6 Weeks After Upper Gastrointestinal Imaging

Delayed Awareness of the History of Barium Examination: Perforated Barium Appendicitis

A Barium Swallow Study Leading to an Incidental Finding on a Screening Colonoscopy

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