Barium peritonitis

Dr Daniel J Bell and Dr Henry Knipe et al.

Barium peritonitis is a rare complication of gastrointestinal fluoroscopy, and occurs when there is gastrointestinal tract perforation and spillage of barium contrast agent into the peritoneal cavity.

Pathology

Barium sulfate in the peritoneal cavity is treated as a foreign body with resultant immune response that has two phases 1-4:

Treatment and prognosis

Early laparotomy and washout/removal of barium has been shown to be beneficial. In the acute phase intravenous fluid replacement may be needed to counter the large volume of ascites and hypovolemia that can develop 1,2. Mortality is high at ~35% (range 20-53%), and is increased if there is concomitant bacterial peritonitis 1,4.

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Article information

rID: 43064
Synonyms or Alternate Spellings:
  • Peritonitis from barium

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Cases and figures

  • Case 1a: chronic
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  • Case 1b: chronic with small bowel obstruction
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