What's the most likely diagnosis?
- 48 year-old with abdominal pain following a test
Maximum Intensity Projection Image (MIP) from a CT Urogram
- Meconium peritonitis
- Multiple gunshot wounds
- Thorotrast administration
- Extraluminal barium
- Old TB
Additional Image - Conventional abdominal radiograph on another patient
Additional Image
Conventional abdominal radiograph on
another patient with same problem
Answer:
4. Extraluminal barium from perforation during barium enema
More (Click Discussion Tab)
Barium Perforation into the Peritoneal Cavity
General Considerations
- Barium sulfate is used as a contrast agent for, amongst other things, barium enema examinations
- It is inert, radiopaque and provides excellent anatomical detail
- On very rare occasions, a perforation may occur allowing the administered barium to leak into the peritoneal cavity
- Barium peritonitis may occur from an inflammatory reaction
- Intestinal content, e.g. fecal material, which also spills into the peritoneal cavity at the same time may play a role in producing sepsis
- “Sterile” barium contamination will still cause peritonitis, but it may not be accompanied by the same degree of sepsis
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