Images in Clinical Medicine
A Deadly Examination
N Engl J Med 2003; 348:1016March 13, 2003
- Article
An 80-year-old man underwent esophagogastroduodenography with barium contrast medium to investigate long-standing dysphagia. During the examination, the patient aspirated contrast material into his lungs. Forty-eight hours later, he presented with a dry cough, fever, tachypnea, and hypotension. The chest radiograph shows massive bilateral aspiration of barium. The patient was immediately intubated, mechanically ventilated, and treated with broad-spectrum antibiotics and vasopressors. Despite aggressive medical treatment, refractory hypotension developed, and the patient died. Aspiration of large amounts of barium sulfate is an uncommon complication of radiologic studies of the upper digestive tract. The problem is generally not serious, because barium sulfate is inert. However, several deaths have been reported in the literature, especially in elderly patients such as ours.
Oren Fruchter, M.D.
National Institutes of Health, Bethesda, MD 20892-1583Robert Dragu, M.D.
Rambam Medical Center, Haifa 31096, Israel- Citing Articles (4)
Citing Articles
1
Sivan Berger-Achituv, Rivka Zissin, Zeʼev Shenkman, Michael Gutermacher, Ilan Erez. (2010) Gastric Emptying Time of Oral Contrast Material in Children and Adolescents Undergoing Abdominal Computed Tomography. Journal of Pediatric Gastroenterology and Nutrition 51:1, 31-34
CrossRef2
Miguel Martínez Martín, Paloma Gil Martínez. (2010) Neumonitis aspirativa por contraste de bario en paciente mayor en estudio por disfagia progresiva. Revista Española de Geriatría y Gerontología 45:3, 173-174
CrossRef3
James T. Wu, Kenneth L. Mattox, Matthew J. Wall. (2007) Esophageal Perforations: New Perspectives and Treatment Paradigms. The Journal of Trauma: Injury, Infection, and Critical Care 63:5, 1173-1184
CrossRef4
(2003) Aspiration of Barium. New England Journal of Medicine 348:25, 2582-2583
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