title: Perforation of the rectum and colon during barium enema examination. Report of four cases.
abstract: BACKGROUND
  The barium enema examination (BEE) is an important diagnostic study and considered to be safe without adverse effects. Perforation of the bowel is rare but is the most frequent complication of BEE and can be life-threatening.
  
  
  METHODS
  We report four cases of barium extravasation due to BEE treated at our institution, three rectal perforations and one perforation in the descending colon.
  
  
  RESULTS
  The four patients underwent surgery because signs of peritonitis developed. Two of them recovered and two died from multiple organ failure.
  
  
  CONCLUSIONS
  Perforation of the colon and rectum during BEE constitutes a surgical emergency in most cases. Prompt recognition and management are vital in decreasing morbidity and mortality.
authors.affiliation: Department of General Surgery, Hôtel-Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon. dbabboud@yahoo.fr
authors.forename: Bassam
authors.initials: B
authors.lastname: Abboud
authors.forename: Toufic
authors.initials: T
authors.lastname: Ata
authors.forename: Ghassan
authors.initials: G
authors.lastname: Chakhtoura
authors.forename: Henri
authors.initials: H
authors.lastname: Ingea
authors.forename: Cyril
authors.initials: C
authors.lastname: Tohme
authors.forename: Pierre
authors.initials: P
authors.lastname: Farah
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003287:Contrast Media / Q000008:administration & dosage*; D004733:Enema / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D008875:Middle Aged; D012007:Rectum / Q000293:injuries*
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate