Retained barium in the appendix or right ureteric colic? A case report of surgeons dilemma

Retention of barium in the vermiform appendix for more than 72h following barium meal study is uncommon. It may produce undue concern for increased risk for appendicitis and even prophylactic appendectomies have been performed for this.

We encountered one such patient who presented with X-ray plate suggestive of tubular radio-opacity in the right iliac fossa region. The patient had episodes of severe pain in the right lower abdomen for which he underwent barium meal study. Further evaluation and investigations established the diagnosis as, a case of recurrent right ureteric colic with retained barium in the appendix.

Review of the literature suggests that, in absence of acute appendicitis there is no role of appendectomy, even in a case of retained barium in the appendix.

If atypical presentation is there, they should be appropriately further investigated.