Surgical Management of Barium Impaction: A Case Report

Radiographic studies are used within healthcare on a routine basis to aid in the diagnosis and management of patients with a variety of health conditions. Barium sulfate is a contrast agent that may be used to enhance certain imaging studies. Although barium-contrasted studies are generally safe, they are not without risk for complications. Barium impactions, and their management, are infrequently reported in scientific literature. We present a case of a patient with barium impaction who presented at the emergency room after a fall from standing with associated symptoms of abdominal pain, weakness, and fatigue. A non-contrast computed tomography (CT) scan performed on presentation revealed the barium impaction, and initial attempts at conservative management were unsuccessful. A decompressive colonoscopy was performed without successful dissolution of the barium. Ultimately, the patient underwent exploratory laparotomy, which revealed a contained perforation of the sigmoid colon, and a successful partial colectomy with end colostomy was performed. This case study explores the surgical management of barium impaction in a comorbid patient.