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Colorectal perforation following barium examination in children

E A Ameh1, N D Chom

  • 1Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.

The Nigerian Postgraduate Medical Journal
|April 30, 2003
PubMed

Insights

Colorectal perforation during barium contrast studies is rare in children. Management varies, with surgical repair and non-operative approaches both proving successful in two pediatric cases.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Gastrointestinal Radiology

Background:

  • Barium contrast studies, such as barium enemas and colostograms, are common diagnostic tools in pediatric patients.
  • Complications like colorectal perforation are infrequent but serious.
  • Hirschsprung's disease is a condition often investigated using these contrast studies.

Observation:

  • A 2-month-old infant with suspected Hirschsprung's disease experienced an intraperitoneal rectal perforation after a barium enema.
  • A 4-year-old child with known Hirschsprung's disease and a colostomy had a colorectal perforation during a distal colostogram with barium.
  • Both pediatric patients were successfully treated, one surgically and the other non-operatively.

Findings:

  • Colorectal perforation is an uncommon but significant complication of barium contrast studies in children.
  • Management strategies for this complication can include surgical intervention (repair and colostomy) or non-operative approaches.
  • Successful outcomes were achieved in both reported cases, regardless of the management method.

Implications:

  • This study highlights the importance of recognizing and managing rare colorectal perforations following barium studies in pediatric populations.
  • It suggests that a tailored approach to management, considering the specifics of the perforation and patient condition, is crucial.
  • Further discussion on the optimal management of this rare complication is warranted to guide clinical practice.

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