title: Barium peritonitis--following barium enema of the proximal colon through a colostomy.
abstract: Perforation with extravasation of barium is a rare complication of contrast enema examination of the large bowel with a high associated mortality rate. The experience of performing a re-laparotomy in a patient previously exposed to barium peritonitis is even less common. We describe an elderly male patient with a Hartmann's procedure performed a year previously, presenting with peritonitis following barium enema evaluation of the proximal colon via an end descending colon stoma. Emergency laparotomy, segmental bowel resection and liberal peritoneal toilet resulted in a satisfactory outcome. The patient had a subsequent successful reversal of his Hartmann's procedure nine months later despite the presence of dense barium induced adhesions. This potentially preventable iatrogenic complication is discussed in this report, which is supplemented by a brief review of the English literature.
authors.affiliation: Department of Surgery, Universiti Putra Malaysia, Jalan Masjid (HKL) 50586, Kuala Lumpur.
authors.forename: N C
authors.initials: NC
authors.lastname: Liew
authors.forename: Tikfu
authors.initials: T
authors.lastname: Gee
authors.forename: K
authors.initials: K
authors.lastname: Sandra
authors.forename: Y A
authors.initials: YA
authors.lastname: Gul
mesh_terms: D000368:Aged; D001466:Barium Sulfate / Q000008:administration & dosage / Q000009:adverse effects*; D003106:Colon; D003125:Colostomy; D004733:Enema / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D010538:Peritonitis / Q000139:chemically induced*
chemical_list: D001466:Barium Sulfate