Two Cases of Colonic Perforation Following Upper Gastrointestinal Barium Examinations

This report presents two cases of colonic perforation that occurred following an upper gastrointestinal series (UGIS) with barium as part of a health screening. UGIS is a widely performed examination in Japan and is useful for the early detection of gastric cancer and peptic ulcers, but it carries a rare risk of causing serious gastrointestinal perforation. This study details the mechanisms of perforation, risk factors, difficulties in imaging diagnosis, and treatment options. Cases of perforation require early diagnosis and appropriate surgical intervention, with Hartmann's procedure or colostomy being the common choices. This case series emphasizes the need to recognize the potential risks associated with UGIS, even though it is considered relatively safe. With the advancement of endoscopic examination technology in recent years, endoscopy is increasingly being adopted as an alternative to UGIS in health screenings, and there is a need to reconsider future examination methods.