Fatal Complications Related to Diagnostic Barium Enema

S, Rimarenko; Finkel, Lawrence J.; Ml, Taff; Mf, Weiss; Is, Schwartz; Federman, Q; Lr, Bogliol

doi:10.1097/00000433-198803000-00022

Cited by 6 publications

(3 citation statements)

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“…Small amount of barium within peritoneal cavity. Peritoneal body atrophy.Gynecologic consultation, observation.Survival with no adverse sequelae after 2 wk and 3 mo.13 [6]811988Vaginal hemorrhage noted after third catheter insertion attempt, procedure immediately stopped. Patient disoriented and febrile to 101 degrees Fahrenheit in the emergency room; radiologic evaluation showed barium obscuring the lower half of the abdomen.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for vaginal intubation may include postmenopausal status, increased parity, attenuation of the perineal body, pelvic surgery, or previous episiotomy [1]. An uncooperative or obtunded patient may also increase the risk for misplacement, as the patient cannot indicate misplacement to the radiology team [6]. Postmenopausal status is associated with vaginal atrophy and decreased lubrication which may make the vagina more susceptible to trauma [7], [8], [9].…”

Section: Discussionmentioning

confidence: 99%

“…Of the reported cases, only 2 mentioned the specific management of the vaginal wound. In 1 case, the wound was irrigated and packed [6]. In the second case the vaginal wound was sutured closed without further adverse sequelae [5].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Vaginal laceration during barium enema with extraperitoneal extravasation: Case report and literature review

Towers¹,

Ng²,

Maxwell³

et al. 2019

Radiology Case Reports

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Unrecognized vaginal intubation during the barium enema procedure with subsequent balloon inflation and contrast instillation is a potentially fatal complication of an otherwise common and routine procedure. We describe a patient who, while undergoing a routine barium enema, had misplacement of the enema catheter into the vagina, subsequent rupture of the superior/lateral vagina upon inflation of the catheter retention balloon, and injection of barium contrast into the retroperitoneum. The patient was admitted for surgical repair of the vaginal laceration and monitoring for chemical peritonitis; and was managed without exploratory laparotomy. We review the existing literature, summarize 18 reported cases from worldwide literature, detail potential complications and propose management and prevention strategies based on the mechanism of injury.

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