A Case of Colon Perforation Caused by Fecaloma of Barium after Upper Gastrointestinal Radiography

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  • 上部消化管造影検査後のバリウム糞石により大腸穿孔を起こした1例

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Abstract

A 50-year-old woman developed acute abdominal pain seven days after receiving upper gastrointestinal radiography. She was admitted to a different hospital, but later was transferred to our hospital because of suspension of defecation and progression of anemia. Abdominal computed tomography showed free air around the sigmoid colon and leakage of barium from the intestinal tract. It also showed a huge barium shadow with strong artifact in the pelvic floor. She was diagnosed with colon perforation and an emergency operation was performed. In the intraoperative findings, perforation occurred on the mesenteric side of the sigmoid colon with necrotic change. A hard foreign body the size of an egg was detected in the rectum. We performed Hartmann's operation and peritoneal drainage. The foreign body was extracted from the rectum, and was found to be fecaloma of barium. The resected specimen showed no diverticulum or neoplasm except for a clear hole 34mm in diameter. Colon perforation after upper gastrointestinal radiography is rare, but sometimes leads to a severe outcome. We report this case of colon perforation by fecaloma of barium with a review of the literature.

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