Clinical and Radiological Dissociation in Massive Barium Aspiration

Abstract

Barium studies are commonly used to rule out gastrointestinal (GI) pathologies and sometimes they are associated with complications such as barium aspiration with heterogeneity in clinical features ranging from mild to severe symptoms. We present a case of large volume barium aspiration in a 73-year-old male with past medical history of dysphagia diagnosed with diffuse esophageal spasm. Barium is an inert material commonly used for GI tract study. Although complications associated with barium studies are rare, aspiration of barium can have dramatic findings resulting in mild to severe symptoms. Clinically patient had very minimal symptoms but radiographic studies appeared dramatic. Therefore, a clinical and radiographic paradox must be kept in mind when evaluating patients and reviewing large volume barium aspiration imaging. Our case remained asymptomatic and had no respiratory complaints, nor did he develop any respiratory distress post barium aspiration.

A Clinical and Radiographic Paradox in a Case of Barium Aspiration

“…A case similar to this was published by Pata et al, where the patient was mainly asymptomatic and did not require intubation. However, the present case differs from their case in age and bilateral aspiration of the barium sulfate [ 2 ]. However, this case shares similarities with their case in a clinical and radiographic paradox where the chest radiograph was suggestive of aspiration, but the patient was clinically stable [ 2 ].…”

“…Most of these cases occur in healthy asymptomatic individuals, are self-limiting, and require no treatment [ 1 ]. The issue becomes necessary when the aspiration is life-threatening [ 2 ]. The barium swallow test is a standard test routinely done to determine the common issues related to the gastrointestinal (GI) tract [ 2 ].…”

“…The issue becomes necessary when the aspiration is life-threatening [ 2 ]. The barium swallow test is a standard test routinely done to determine the common issues related to the gastrointestinal (GI) tract [ 2 ]. Barium sulfate is a contrast that is inert and causes no harm to the GI tract [ 3 ].…”