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February 16, 1976

Barium Intravasation Into Portal Venous System During Barium Enema Examination

Author Affiliations

From the departments of radiology (Drs Salvo and Capron) and surgery (Dr Dillihunt), Maine Medical Center, Portland, and the Department of Radiology, S. D. Goodall Hospital (Dr Leigh), Sanford, Me.

JAMA. 1976;235(7):749-751. doi:10.1001/jama.1976.03260330043023

BARIUM enema examination has had a very low complication rate, approximately two in 10,000 studies. During a 20-year period at the Columbia Presbyterian Hospital (New York), Seaman and Wells1 found only 13 examples of perforation of the colon during barium enema examination. We have recently encountered a unique complication of the barium enema, one that has been reported only once before, to our knowledge, ie, intravasation of barium into the portal venous system. This occurred during a barium enema examination of a patient with ulcerative colitis.

Report of a Case  A 36-year-old woman had had upper gastrointestinal bleeding, thought to be from a duodenal ulcer, in 1970 and 1972; both episodes were controlled medically. The patient had a history of chronic alcoholism. Approximately one month before admission, she experienced weakness, anorexia, and nausea, and passed several black stools. She had also lost 4.5 kg (10 lb) during this month.