The Therapeutic Barium Enema Revisited

Chorost, Mitchell I.; Fruchter, Gerald; Kantor, Alan; Wu, James S.; Ghosh, Bimal C.

doi:10.1053/crad.2001.0805

Cited by 9 publications

(11 citation statements)

References 10 publications

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“…In all cases, the concentration of barium was 200%, the volume was 400 mL, and the enema tip was withdrawn one hour after the therapy (Table 1). In our four cases, although no severe complications of therapeutic barium enema (such as perforation) occurred, we have to take into account the Iwamoto (Table 2) [8,[18][19][20] . A previous case report [8] presented successful treatment with a high concentration of barium with 1 mg of epinephrine.…”

Section: Discussionmentioning

confidence: 99%

“…In that case, epinephrine was added to the solution for vasoconstriction; but the possible adverse effects of epinephrine such as sudden hypertension were not ruled out. Another case report [18] presented successful treatment with a 20% barium sulphate solution at a height of 0.9 m for 5 min. In 1970, Adams et al [19] demonstrated that 26 of 28 acute bleeding episodes were arrested by therapeutic barium enema with a 20% concentration of barium.…”

Section: Discussionmentioning

confidence: 99%

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Therapeutic barium enema for bleeding colonic diverticula: Four case series and review of the literature

Iwamoto¹,

Mizokami²,

Shimokobe³

et al. 2008

WJG

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The prevalence of diverticular diseases of the colon, including severe and persistent bleeding in Eastern countries, has increased in the last decades. The bleeding from colonic diverticula is the most common cause of acute lower gastrointestinal bleeding. Herein, we report four cases of severe and persistent bleeding of colonic diverticular disease that could be treated with a high concentration barium enema. These four cases showed a similar pattern of bleeding whose source could not be identified. Colonoscopy revealed fresh blood in the entire colon and many diverticula were noted throughout the colon. No active bleeding source was identified, but large adherent clots in some diverticula were noted. After endoscopic and angiographic therapies failed, therapeutic barium enema stopped the severe bleeding. These patients remained free of re-bleeding in the follow-up period (range 17-35 mo) after the therapy. We report the four case series of therapeutic barium enema and reviewed the literature pertinent to this procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Therapeutic barium enema for bleeding colonic diverticula: Four case series and review of the literature

Iwamoto¹,

Mizokami²,

Shimokobe³

et al. 2008

WJG

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“…These methods, however, are not helpful for presumed diverticular bleeding, cases in whom the bleeding source is not visualized endoscopically and the bleeding is not brisk enough to be detected by angiography. Previous reports suggested that therapeutic barium enema could achieve hemostasis in refractory diverticular bleeding [6, 7]. We present the case of an elderly patient with presumed diverticular bleeding that could not be treated with endoscopic or angiographic measures.…”

Section: Introductionmentioning

confidence: 91%

Therapeutic High-Density Barium Enema in a Case of Presumed Diverticular Hemorrhage

Pausawasdi

Al-Hawary²,

Higgins³

2011

Case Rep Gastroenterol

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Many patients with lower gastrointestinal bleeding do not have an identifiable source of bleeding at colonoscopy. A significant percentage of these patients will have recurrent bleeding. In many patients, the presence of multiple diverticula leads to a diagnosis of presumed diverticular bleeding. Current treatment options include therapeutic endoscopy, angiography, or surgical resection, all of which depend on the identification of the diverticular source of bleeding. This report describes a case of recurrent bleeding in an elderly patient with diverticula but no identifiable source treated successfully with barium impaction therapy. This therapeutic modality does not depend on the identification of the bleeding diverticular lesion and was well tolerated by our 86-year-old patient.

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“…Only one case of the embolization of the responsible artery has so far been reported [14]. As the therapeutic use of a barium enema has recently been shown to be a useful procedure to treat diverticular bleeding [23,24], we thought that the use of a therapeutic barium enema could also be a practical and less invasive option for controlling such intractable appendix bleeding. In fact, the present case is the first reported case in which a therapeutic barium enema successfully controlled such bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…After washing the orifice with water, a hemorrhage was detected in the appendix (Figure 1B), and the lesion responsible for bleeding was regarded to exist in the appendix. After obtaining the patient’s informed consent, 200 ml of 50 W/V% barium was sprayed into the orifice of the appendix using a spraying tube (Figure 1C), because a therapeutic barium enema has been shown to be a useful procedure to control bleeding from a diverticulum [23,24]. The bleeding could be immediately stopped, and a radiological examination revealed the accumulation of barium at the cecum and the orifice of the appendix (Figure 2A).…”

Section: Case Presentationmentioning

confidence: 99%

A therapeutic barium enema is a practical option to control bleeding from the appendix

et al. 2013

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BackgroundAcute lower gastrointestinal hemorrhage originating from the appendix is rare and often intractable, because it is almost impossible to approach the bleeding point by endoscopy. We herein describe the first case of bleeding from the appendix, which was successively controlled by a therapeutic barium enema administered into the appendix.Case presentationA 71-year-old male visited our hospital because of melena. He has been receiving an anti-coagulation drug, ticlopidine hydrochloride, for 10 years. By an emergency colonoscopy, a hemorrhage was detected in the appendix, and the lesion responsible for the bleeding was regarded to exist in the appendix. Two hundred milliliters of 50 W/V% barium was sprayed into the orifice of the appendix using a spraying tube. The bleeding could thus be immediately stopped, and a radiological examination revealed the accumulation of barium at the cecum and the orifice of the appendix. The barium accumulation disappeared by the next day, and no obvious anal bleeding was observed. Two weeks after stopping the bleeding from the appendix, an appendectomy was performed to prevent any further refractory hemorrhaging. The patient has had no complaints of any abdominal symptoms or anal bleeding for 10 months.ConclusionsA therapeutic barium enema is a useful procedure to control bleeding from the appendix and to avoid emergency surgery, such as partial cecectomy and hemicolectomy.

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The Therapeutic Barium Enema Revisited

Cited by 9 publications

References 10 publications

Therapeutic barium enema for bleeding colonic diverticula: Four case series and review of the literature

Therapeutic barium enema for bleeding colonic diverticula: Four case series and review of the literature

Therapeutic High-Density Barium Enema in a Case of Presumed Diverticular Hemorrhage

A therapeutic barium enema is a practical option to control bleeding from the appendix

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