[Lethal barium sulfate embolism after accidental vaginal application (author's transl)]

The case of a 63-year-old woman is presented to whom a barium sulfate enema was administered accidentally into the vagina. During inflation of the stop manchette a deep bilateral laceration of the vaginal mucosa occurred which was neglected initially. Thus, venous vessels were ruptured and the subsequent insufflation of the barium sulfate suspension resulted in a direct injection to the afferent veins and a peracute, massive pulmonary embolism. Within 1 min irreversible heart failure followed. The case differs in some aspects from two similar cases referred to in the literature, where death occurred 15 h and 3 days, respectively, after enema.