Small bowel obstruction of barium for gastric cancer screening

Surgical Management of Barium Impaction: A Case Report

“…The presentation for a barolith impaction can vary from mild nausea to severe abdominal pain and distention. In our patient's case and others in the literature, common presenting signs on admission were abdominal pain and an elevated white count [2,[4][5][6][7][8][9][10]. Our patient did reveal that she had not had a recent bowel movement, which helped direct our treatment plan.…”

“…Therefore, patients should be educated and counseled on adequate fluid intake postbarium study [8]. The use of laxatives has been reported to aid in barium clearance as routine post-barium study care as well as a conservative treatment option [7][8][9]. Additionally, patients should be aware to report a lack of bowel movements to their physician.…”

“…If a barium impaction is suspected, an abdominal X-ray should be completed to discern between any remaining barium or complete barium removal [ 6 ]. Once barium has impacted, however, the risk of morbidity and mortality increases dramatically [ 7 ]. Therefore, patients should be educated and counseled on adequate fluid intake post-barium study [ 8 ].…”

“…Literature reports that once swallowed, barium is cleared from the colon within one week in 57% of patients, with barium completely cleared within four weeks in most patients [ 9 ]. In patients complicated with barium impaction, the mean day of bowel obstruction is three days [ 7 ]. The most common places for barium obstructions to form are the descending and rectosigmoid colon [ 2 , 9 ].…”