[Intra- and sub-peritoneal effusions of barium. A report on 16 cases (author's transl)]

The authors report 16 cases of intra or retro-peritoneal effusion of barium due to colorectal or gastroduodenal perforations. Possible mechanisms and the consequences of barium loss are discussed. Treatment must be directed towards repair of the visceral perforation, usually in the colon or rectum, employing exteriorization or resection but without initial anastomisis, and must treat associated peritonitis by very careful extensive cleaning of the peritoneal cavity. In certain well-defined cases, sub-peritoneal perforation can be treated conservatively. The high mortality rate of about 40% can be explained by the particular type of bacterial potentiation due to barium sulfate. Preventive measures are outlined, including the use of water soluble contrast media in some selected cases.