Three cases of colorectal perforation due to barium retention after gastrography

Abstract

Colorectal perforation is a rare complication of barium gastrography. Most of these patients have some underlying colorectal disease such as diverticulum or cancer which contributes to the perforation. Few cases of the disease arisen from only barium retention have been reported. We present three cases of this disease with a review of the literature.
Case 1 involved a 71-year-old male. Two days after gastrography, stomachache occurred following the first barium evacuation. Hartmann's operation was performed for rectal (Ra anterior wall) perforation. Case 2 involved a 70-year-old female. Intermittent stomachache occurred on the next day after gastrography, followed by intensified pain two days later. Expansion of the sigmoid colon with barium was visualized, and a medium amount of evacuation was seen. On the next day, severer pain occurred and Hartmann's operation was performed for sigmoid colon perforation (mesentery side). Case 3 involved a 73-year-old female. Barium evacuation was only a little after gastrography. Stomachache occurred three days after gastrography, and Hartmann's operation was performed for sigmoidal colon perforation (anterior wall).
Although colorectal perforation after barium gastrography is rare, it is iatrogenic and sometimes results in unfortunate outcome. Much attention to this disease and confirmation of the amount of barium evacuation are essential.