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Rectal perforations after barium enema: a review
Peter W de Feiter1, Peter B Soeters, Cornelis H C Dejong
1Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands. pdf@home.nl
Diseases of the Colon and Rectum
|December 6, 2005
Summary
Rectal perforation from barium enema is rare but serious. Advances in care have lowered mortality, but newer imaging techniques may replace barium enemas.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Complications
Background:
- Rectal injuries during barium enema are rare but life-threatening complications.
- The last comprehensive review on this topic was published over a decade ago.
Purpose of the Study:
- To provide an overview of rectal injuries from barium enema.
- To focus on evolving treatment strategies and less invasive imaging alternatives.
Main Methods:
- Literature search of PubMed using keywords: barium enema, complications, peritonitis, rectal perforation.
- Inclusion of related articles and references for comprehensive review.
Main Results:
- Iatrogenic, catheter-related injuries are the most common cause of rectal perforation.
- Five types of perforations are described, with intraperitoneal perforations having the highest mortality.
- Conservative management is possible for some perforations, while others require immediate aggressive surgery.
Conclusions:
- Rectal perforations post-barium enema are infrequent, with mortality decreasing due to improved care.
- Endoscopic advancements have reduced barium enema performance and complication rates.
- CT colonography and MRI colonography are emerging as safer, more sensitive alternatives.