Endoscopic removal of an impacted barolith at the sigmoid colon: a rare case report

Abstract

A 45-year-old woman visited our hospital complaining of abdominal pain 1 week after undergoing an annual medical checkup. Her vital signs and blood test results were normal, but tenderness was found in the lower abdomen. A high-density round structure found at the midline of the lower abdomen on an abdominal radiograph was thought to be an accumulation of barium (a barolith) from upper gastrointestinal barium radiography. Two liters of an oral gastrointestinal cleaning agent was administered, but defecation did not occur. Lower gastrointestinal endoscopy revealed that the barolith was impacted at the sigmoid colon. We unsuccessfully attempted to move it using a pressurized water jet and forceps, but it was too large to be captured by the net. Therefore, we broke it down using a snare. After a successful endoscopic procedure, 120 mL of a glycerin enema solution was injected through the forceps opening, causing the barolith to be excreted. There is only one similar case of successful endoscopic treatment of a barolith in the literature.