Rare and lethal complication of barium enema intravasation

Abstract

Barium enema investigation is regarded as a safe investigative procedure. Rarely, it may cause complications such as colonic perforation and barium intravasation. Barium intravasation may be caused by the inadvertent introduction of the catheter into the vagina, thereby into the vaginal venous plexus. It may also occur through mechanical colonic perforation with the catheter, or via diseased bowel conditions. This may lead to complications such as liver microabscesses, massive pulmonary embolism, hypovolemic shock, disseminated intravascular coagulopathy and even sudden death. With that in mind, we would like to report an interesting case of barium intravasation into the portal venous system via the vagina venous plexus. The patient experienced abdominal discomfort with mild per vaginal bleed and went into disseminated intravascular coagulopathy. She received supportive management and she made a full recovery.

Eight Clinical Cases and the Lessons They Taught

“…While the technician in this case may seem incredibly incompetent, a recent (done for this column) advanced PubMed search using barium and embolism as key words yielded 51 results, with the first one reported in 1952 3 and the most recent reported in 2018 4 …”