Two Cases of Barium Peritonitis

Postmortem computed tomography of barium peritonitis due to descending colon perforation

“…Although diagnosis of barium peritonitis is easy with evidence of extraintestinal barium in clinical settings [4] , free gas in the peritoneal cavity on PMCT must be interpreted with caution [9] . In the absence of penetrating injury or resuscitative measures, free gas in the peritoneal cavity on PMCT could be due to decomposition, gastromalacia, or pathological (antemortem) bowel perforation.…”

“…Gastrointestinal contrast studies include barium enema and upper gastrointestinal series. The site of gastrointestinal perforation is in the large intestine in 77.8% [4] and in the sigmoid colon in 70% [14] , overwhelmingly more often than in the stomach or duodenum. About half of these represent colonic perforations after upper gastrointestinal series [5] .…”

“…About half of these represent colonic perforations after upper gastrointestinal series [5] . Perforated sites are reported to be vulnerable sites such as gastric ulcers, ulcerative colitis, and colonic diverticula [ 4 , 5 ]. Catheter-induced colonic mucosal injury during barium enema has also been described [ 4 , 5 ].…”

“…Perforated sites are reported to be vulnerable sites such as gastric ulcers, ulcerative colitis, and colonic diverticula [ 4 , 5 ]. Catheter-induced colonic mucosal injury during barium enema has also been described [ 4 , 5 ]. These sites are perforated by increased intestinal pressure from barium and air.…”

“…Various mortality rates for barium peritonitis have been reported, such as 22.2% [4] , 29% [5] , and 35% [2] . If left untreated, the mortality rate is 100% [6] .…”