Abstract
A 41-year-old man was admitted to our emergency room because of increasing periumbilical pain, which appeared 10 hours after an X-ray examination for gastric cancer screening. Physical examination revealed rebound tenderness and muscular pain and muscular tension in the lower right abdomen. Laboratory studies showed a white blood cell count of 14,800/μL with 89.6 neutrophil and 6.83 mg/dL C-reactive protein levels. Plain computed tomography (CT) scan demonstrated barium retention in the appendix and barium leakage surrounding the appendix. Furthermore, the CT scan demonstrated increased fat density in the surrounding appendix. Based on the patient’s history, as well as the clinical and radiological findings, he was diagnosed with barium appendicitis. The patient received a laparoscopic appendectomy. The appendix appeared enlarged, forming an abscess in the mesoappendix and the localized peritonitis. He was discharged on the fifth day of developing appendicitis. Although barium appendicitis is a rare complication, it is important to consider the possibility of barium appendicitis as one of the causes of acute abdomen after an X-ray examination for gastric cancer screening. An X-ray examiner must recognize barium appendicitis as a complication after an X-ray examination for gastric cancer screening.
