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Reflux of barium into a maxillary antrum
Journal of the Canadian Association of Radiologists
|December 1, 1978
Summary
A patient with achalasia experienced sinus infections due to barium sulfate reflux from a gastrointestinal study. This highlights a rare complication of barium sulfate in patients with swallowing difficulties.
Area of Science:
- Otolaryngology
- Gastroenterology
- Radiology
Background:
- Achalasia is a primary esophageal motility disorder characterized by impaired relaxation of the lower esophageal sphincter and loss of peristalsis.
- Neurologic deficits can compromise swallowing mechanisms, increasing the risk of aspiration and reflux.
- Upper gastrointestinal studies utilizing barium sulfate are diagnostic tools for evaluating esophageal and gastric motility.
Observation:
- A patient diagnosed with achalasia and a concurrent neurologic deficit presented with unilateral maxillary sinusitis.
- The patient had undergone an upper gastrointestinal study involving barium sulfate administration.
Findings:
- Radiographic imaging revealed a dense material within the inflamed maxillary sinus, consistent with barium sulfate.
- The presence of barium sulfate in the sinus cavity strongly suggests reflux from the upper gastrointestinal tract into the nasopharynx and subsequently into the sinus.
Implications:
- This case illustrates a rare but significant complication of barium sulfate use in patients with achalasia and impaired swallowing.
- It underscores the importance of considering reflux of contrast agents as a potential etiology for sinusitis in susceptible patients.
- Clinicians should be aware of this potential pathway for barium sulfate migration, particularly in patients with known swallowing abnormalities.