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

Saigusa, Susumu; Ohi, Masaki; Oki, Satoshi; Ichikawa, Takashi; Kobayashi, Minàko; Inoue, Yasuhiro; Miki, Chikao

doi:10.1155/2017/6316175

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Barium appendix can be confused with metal foreign bodies and in the present case ( 8 ), the possibility of foreign bodies existed because swallowing of foreign bodies is well-known phenomenon among children. Therefore, a history of a UGI was the main clue ruling out foreign bodies.…”

Section: Discussionmentioning

confidence: 58%

“…An appendectomy should be performed if a clinical suspicion of acute appendicitis or chronic right lower quadrant stress exists with retained barium in the appendiceal lumen, to prevent the risk of development of acute appendicitis with perforations ( 8 , 9 ). In our case, the pain was originally periumbilical, but later spread to the right lower quadrant.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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: 58%

Section: Discussionmentioning

confidence: 99%

Barium Appendicitis 6 Weeks After Upper Gastrointestinal Imaging

Shen

Sun

2020

Front. Pediatr.

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Retained Barium in the Appendix Is Difficult to Distinguish from Surgical Remnants following Laparoscopic Surgery

Sato

Koizumi

Hino

et al. 2018

Case Reports in Obstetrics and Gynecology

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Surgical materials, such as gauze, can be accidentally left inside of patients following surgery. This iatrogenic complication should be avoided and is often prevented by routine X-ray analysis after surgical abdominal procedures. We report a case of retained barium in the appendix that was difficult to distinguish from surgical remnants. A 41-year-old Japanese female was diagnosed with uterine leiomyoma and underwent laparoscopic myomectomy. The postoperative X-ray test showed a cord-like material in the lower right abdomen that was not captured in the preoperative X-ray test two months prior to the operation. Because of this difference, the area was reexamined laparoscopically. After examination, we concluded that the cord-like material in X-ray tests was in fact retained barium in the appendix. Barium can be retained in the appendix for long periods of time, and retained barium in the appendix can be captured radiographically and can mimic the appearance of surgical remnants, appearing as a cord-like material. The knowledge above combined with detailed interviews before surgery could prevent such confusion during interpretation of X-ray tests after surgery.

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Appendiceal mucinous neoplasm with myxoglobulosis occurring 3 years after perforated barium appendicitis: a case report

et al. 2019

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Background Myxoglobulosis is considered a subtype of appendiceal mucinous neoplasm (AMN). Factors affecting the occurrence of myxoglobulosis include proximal appendiceal obstruction and mucosal secretion at the residual appendiceal mucosa. In addition, myxoglobulosis has also been reportedly associated with persistent chronic inflammation. We report a case of AMN with myxoglobulosis occurring 3 years after perforated barium appendicitis and the importance of caution during surgery for barium peritonitis and elucidate the pathology of myxoglobulosis. Case presentation A 45-year-old man with an AMN underwent laparoscopic ileocecal resection 3 years after peritonitis caused by perforated barium appendicitis. The patient had a medical history of perforated barium appendicitis after barium swallow imaging, which was treated conservatively 3 years ago. Computed tomography (CT) revealed cystic enlargement of the appendix and remnant barium around the appendix. He was then pathologically diagnosed with a low-grade AMN based on the resected specimen, and the appendix filled with white globules was diagnosed as myxoglobulosis. When barium is not absorbed, it causes chronic inflammation. As barium was observed around the appendix, prolonged inflammation, and appendicitis may have contributed to the myxoglobulosis. The circumference of the appendix firmly adhered to the surrounding tissue with barium; hence, it was difficult to perform appendectomy. Barium that enters the anastomotic site causes stenosis of this part; therefore, excision of the ileocecal region in the intestinal part where barium is not present was selected instead of appendectomy. Colonoscopy performed 1 year after surgery and showed no evidence of anastomotic stricture. Conclusion This case suggested that barium peritonitis caused strong adhesions with the surrounding tissue; thus, careful manipulation was necessary to avoid perforating the appendix. Appendectomy and partial cecal resection were predicted to be difficult because of adhesion by barium. In addition, the ileocecal resection was selected because we had to choose an anastomotic site without barium. The perforated appendicitis caused stenosis of the appendix orifice, and barium surrounding the appendix caused persistent chronic inflammation. This was suggested to contribute to the myxoglobulosis.

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

Cited by 3 publications

References 11 publications

Barium Appendicitis 6 Weeks After Upper Gastrointestinal Imaging

Barium Appendicitis 6 Weeks After Upper Gastrointestinal Imaging

Retained Barium in the Appendix Is Difficult to Distinguish from Surgical Remnants following Laparoscopic Surgery

Appendiceal mucinous neoplasm with myxoglobulosis occurring 3 years after perforated barium appendicitis: a case report

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