Barolith precipitation: an uncommon sequela following barium imaging

We present the case of a young male in his mid-30s who developed baroliths, a rare complication, following a barium contrast study. The patient initially presented with abdominal pain, vomiting and constipation. Imaging revealed two large masses of retained contrast material within the sigmoid colon and rectum, consistent with baroliths. Despite initial conservative management, including enema and electrolyte correction, the patient required surgical intervention due to persistent symptoms. An exploratory laparotomy and rigid sigmoidoscopy were performed to remove the impacted stool, leading to symptom resolution. This case highlights the need for vigilance in keeping baroliths as a differential in patients presenting with signs of gastrointestinal obstruction with a history of recent barium studies and emphasises the importance of preventive measures, early recognition and tailored management to prevent severe complications.