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PubMedDate not supplied

[Barium peritonitis: experimental study using barium sulfate and radioactive barium].

Barium peritonites are known to be a serious complication of barium enema examinations, being accompanied by a high mortality rate. The authors made their study injecting barium and radioactive 133Ba in the peritoneum of 68 rats without causing damages to the colon, in order to verify the toxicity of barium if injected in the peritoneum, and to evaluate the various extraperitoneal locations. Moreover, they compared the alterations caused by this agent with those consequent to a similar agent, such as talcum. The results show that barium is not toxic on its own: it gives in fact origin to granulomas similar to those caused by talcum; a particular tropism for the lymphatic tissues is present as well.

Animals↗
PubMed1994

[A study of aspiration in infants with recurrent pneumonia by Barium swallow examination using different concentrations of barium].

We conducted barium swallow examinations using different concentrations of barium sulfate suspension (10, 30, 60 w/v%) in infants with recurrent pneumonia. Aspiration of swallowed barium into the airway was demonstrated in 43 of 54 infants (44 of 56 examinations). Of these, 22 infants had no neurological or anatomical abnormality. In comparing the degree of aspiration and the barium concentration, it was found that the higher the concentration of barium, the less severe the degree of aspiration tended to be. There was no infant in whom thicker barium aggravated aspiration. The difference in the degree of aspiration was considered to be attributable to difference, in the viscosity of barium. The results of our study showed aspiration to the airway was more frequent than previously reported, and occurred even in infants without any other abnormality. The detectability of aspiration was dependent on the concentration of barium sulfate suspension. Because the viscosity of conventionally used milk is identical to that of 10-20 w/v% barium, 10-20 w/v% barium should be used in barium swallow examinations for infants with recurrent pneumonia.

Barium Sulfate↗
PubMed1997

Low density barium and bentonite mixture versus high density barium: a comparative study to optimize negative gastrointestinal contrast agents for MRI.

The purpose of this study was to compare the patient tolerance and efficacy, as magnetic resonance imaging negative oral contrast agents, of a mixture of clay compound bentonite and low density barium sulfate suspension with that of higher density barium sulfate. Twenty patients were randomized into two groups: 10 patients receiving a mixture of low concentration 60% w/v barium sulfate plus 2.5% w/v bentonite, and 10 patients receiving 220% w/v barium sulfate Liuqid-HD (E-Z-EM, Westbury, NY). Post-contrast Spin-echo (SE) T1- and T2-weighted images (WI) were obtained on a 1.0T magnet. Two independent readers scored the overall intraluminal signal intensity and delineation of the gastrointestinal tract and adjacent organs. Patient acceptance was evaluated via a short questionnaire, by recording spontaneous comments and documenting the quantity of contrast agent ingested. There was greater intraluminal bowel signal reduction and organ delineation with 220% w/v barium than with the barium-bentonite mixture on both SE T1WI (p = 0.03) and SE T2WI (p = 0.42). With both agents there was greater signal reduction on SE T2WI than SE T1WI. Higher scores for organ delineation for both contrast agents were seen with SE T1WI. With 220% w/v barium, there was significantly better delineation of the pancreatic body (p = 0.02) and pancreatic tail (p = 0.02) on T1WI compared with SE T2WI. With the barium-bentonite mixture, SE T1WI showed improved delineation of jejunum compared with SE T2WI (p = 0.03). There were no statistically significant differences between the volume of contrast ingested in the two groups. Abdominal cramps were recorded for one patient in each group. These results suggest that barium-bentonite mixture, although useful as a negative gastro-intestinal contrast agent, is not as effective as 220% w/v barium. Further studies with a larger patient population and concentration optimization studies are needed.

Abdomen↗
PubMed1990

Colonic stenoses: use of oral barium when retrograde flow is completely obstructed on barium enema studies.

Forty patients with complete obstruction to retrograde barium flow on barium enema examinations, without clinical or radiographic evidence of obstruction, were studied further with orally administered barium in the same session. All patients had undergone aborted double-contrast barium enema studies and had received antispasmodics intramuscularly before the examination. The authors describe the technique, as well as the clinical and radiologic findings, that allows the safe ingestion of oral barium in patients with stenotic lesions of the colon. In all patients, oral barium passed through the small bowel and the stenotic site in an average of 148 minutes, with no complications. In seven patients, there were synchronous lesions in the colon and small bowel, and the findings were determined better with oral barium studies in 19 patients. If a barium enema study is done and retrograde passage of barium is obstructed by a lesion in the left side of the colon, additional diagnostic information can be obtained by giving the patients oral barium. This practice is safe if precise criteria are applied.

Administration, Oral↗
PubMed2003

Radiation doses for barium enema and barium meal examinations in Ireland: potential diagnostic reference levels.

Wide variations in patient dose for the same examinations have been demonstrated by several studies throughout Europe. By investigating patient dose, variations can be acknowledged, causal agents sought and the necessary adjustments made. Diagnostic reference levels (DRLs) provide a framework with which dose levels from individual hospitals are compared, and when exceeded, corrective actions can be taken where appropriate. This study aimed to establish DRLs for barium enema and barium meal examinations in Ireland. Measurements were recorded using a dose-area product meter in 12 hospitals representing 33% of relevant hospitals. Results demonstrated wide mean hospital dose variation, by up to a factor of 7.8 and 4.2 for barium enema and barium meal examinations, respectively. Minimum and maximum individual patient dose values varied by a factor of 45 for barium enemas and 90 for barium meal examinations. Reasons for dose variations were complex, but major factors for both examinations were fluoroscopy time, secondary radiation grid type and level of filtration. Some examination-specific factors were also noted. DRLs, established using the quantity dose-area product, were calculated to be 47 Gy cm(2) for barium enemas and 17 Gy cm(2) for barium meal examinations. Although the DRL value for barium meals was the same as the reference value established in the UK for that examination in 1996, the barium enema DRL in this study was 45% higher than the relevant UK value.

Barium Sulfate↗
PubMed2001

Patient dose variation investigated in four Irish hospitals for barium meal and barium enema examinations.

Four hospitals have been studied, intra- and inter-hospital variations examined and the mean DAP values recorded for barium enemas and barium meals. Mean DAP values for barium meals and barium enemas at 11.4 Gy x cm2 and 20.1 Gy x cm2 respectively have been shown. Differences between individual examinations for barium meals varied by up to a factor of 185 and for barium enemas, up to a factor of 19, with hospital means for barium meal and enema examinations each differing by up to a factor of 3. The data provided by this study have suggested that large variations in patient dose do exist in Ireland for barium meal and barium enema examinations. Fluoroscopy time was shown to be a major contributor to the variations reported, with number of images playing a minor role. Results have demonstrated the need for standardisation of technique throughout the country for these examinations.

Barium Sulfate↗
PubMed2003

Spasmolytic effect of peppermint oil in barium during double-contrast barium enema compared with Buscopan.

AIM: To evaluate the efficacy of peppermint oil in barium as a spasmolytic agent during a double-contrast barium enema (DCBE). MATERIALS AND METHODS: A total of 383 DCBEs with positive results from occult blood tests were assessed. Patients were assigned to one of four groups: peppermint in barium (n=91), peppermint in tube (n=90), Buscopan (n=105), or no treatment (n=97). After a screening sigmoidoscopy, the DCBEs were performed using air as a distending gas. In the Buscopan group, the DCBE was performed with an intramuscular injection of 20mg Buscopan at the start of the examination. Patients in the no-treatment group underwent DCBE without any spasmolytic agent. A peppermint oil preparation (30ml) was mixed in the barium solution for patients in the peppermint-in-barium group, and the same dose of peppermint oil was included in the enema tube in the peppermint-in-tube group. The presence of spasm on a series of spot films was evaluated without information about the type of spasmolytic agent used. RESULTS: The percentage of patients in the four groups (no treatment, Buscopan, peppermint in tube, and peppermint in barium) with absence of spasm in the entire colon on the series of spot films was 13.4, 38.1, 41.8, and 37.8%, respectively. In the group using peppermint oil or Buscopan, the rate of patients with non-spasm examination was higher than that in no-treatment group (p<0.0005). Peppermint oil had the same spasmolytic effect as the systemic administration of Buscopan in the transverse and descending colon. Peppermint oil had a stronger effect in the caecum and the ascending colon than a Buscopan injection (p<0.005). There was no advantage to placing peppermint oil in the enema tube over mixing it in the barium solution. A total of 157 polyps were found during the DCBE procedures, and no differences were observed in the number of lesions among the four groups. Peppermint oil did not impair image quality. CONCLUSION: Barium solution mixed with peppermint oil was safe and effective for the elimination of colonic spasm during the DCBE procedure, and it could be used instead of Buscopan.

Barium Sulfate↗
PubMed1983

[A case of barium-peritoneum with neurological involvement. Importance of barium determination in biological fluids].

Barium in the peritoneum following a barium enema led to a severe and irreversible chronic barium poisoning, although from the abdominal and gastro-intestinal point of view, there were virtually no sequelae. Barium assay on the cerebro-spinal fluid of this patient revealed excessively high levels, which provides the laboratory evidence of the direct action of barium on the central nervous system. Barium assays on biological fluids after barium-peritoneum could be used to assess the degree of barium poisoning and may have prognostic value.

Aged↗
PubMed1988

Prospective comparison of double contrast barium enema plus flexible sigmoidoscopy v colonoscopy in rectal bleeding: barium enema v colonoscopy in rectal bleeding.

Rectal bleeding often heralds serious colonic disease. The literature suggests that colonoscopy is superior to barium enema plus sigmoidoscopy, although no good comparative studies exist. Seventy one patients with overt rectal bleeding had prospectively flexible sigmoidoscopy, double contrast barium enema and colonoscopy completed independently. Against the gold standard, the sensitivity and specificity of colonoscopy were 0.69 and 0.78 respectively for a spectrum of colonic lesions, while for combined flexible sigmoidoscopy and double contrast barium enema these values were 0.80 and 0.56, respectively. When assessing adenoma or carcinoma, colonoscopy was more sensitive at 0.82 v 0.73, while flexible sigmoidoscopy plus double contrast barium enema was superior for detecting diverticular disease. The positive predictive value for colonoscopy was 0.87 against 0.81 for flexible sigmoidoscopy and double contrast barium enema. This study confirms that colonoscopy should be a first line investigation in subjects likely to require biopsy or therapeutic intervention.

Barium Sulfate↗
PubMed1994

Reduction of patient doses from barium meal and barium enema examinations through changes in equipment factors.

A study of patient doses for barium meal and barium enema examinations has been made for X-ray departments throughout Grampian Region. Dose-area products are substantially less than UK reference levels. Contributions from fluoroscopy and radiography varied significantly between different units, with fluoroscopy making up 35-92% of the mean doses for barium meals and 24-57% for barium enemas. Equipment related factors had a greater influence on patient doses than radiologists' techniques. The gain of the image intensifier and the exposure factors selected by the automatic exposure control (AEC) were the most important factors determining doses for fluoroscopy. Changes in kV/mA factors selected by the AEC have allowed reductions of 20-50% to be made in effective dose from fluoroscopy with some units. The method used for recording images was the major influence on radiographic doses. Digital spot images or fluorographic films taken from the intensifier gave only 10-20% of the dose with a film/screen system and are recommended where the image quality is satisfactory for the application. Changes in film/screen systems have given worthwhile reductions in radiographic doses. If all factors are optimized, mean doses for barium examinations could be reduced to 20% of current reference levels.

Barium Sulfate↗
PubMed2004

Nonfatal barium intravasation into the portal venous system during barium enema examination.

We report a case of barium intravasation in a 66-year-old patient. Unenhanced computed tomography (CT) scan revealed barium and air emboli in portal veins and liver. We believe he survived because his liver prevented inflow of barium into the systemic circulation. To the best of our knowledge, this is the 23rd reported case of venous barium intravasation in the last 50 years. Because all 23 patients had bowel disease or diverticulitis, we conclude barium enema should be used cautiously in such patients.

Aged↗
PubMed1983

The effect of barium enemas and barium sulfate on healing of colorectal biopsy sites.

Twelve mongrel dogs had superficial and deep colon biopsies above and below the peritoneal reflection. Six of the animals were given a barium enema; two had a barium enema immediately, two in three days, and two in six days. The animals were sacrificed 48 hours after the barium enema; the sigmoid was removed and tissue was examined macroscopically and microscopically. When healing rates of the biopsy sites were compared with those of control animals, there was no difference. The results suggest that barium has no deleterious effect on the healing of superficial or deep colorectal biopsies.

Animals↗
PubMed1983

Effect of sodium bicarbonate pretreatment on barium coating of mucosa during double contrast barium meal.

The radiographic pattern of the areae gastricae is produced by barium lying in the intersecting furrows of the gastric mucosal surface. However, if the mucus layer on the gastric mucosa is thick, it interferes with the barium coating of the areae gastricae during double contrast barium meal. As sodium bicarbonate decreases the viscosity of mucus and thus may make the gastric mucus layer thinner, it was evaluated as a pretreatment agent in a routine double contrast upper-gastrointestinal study to improve the visualization of the areae gastricae. In a single blind study, 53 of 106 patients took sodium bicarbonate water mixtures at bedtime the day before and on the morning of the examination. According to the results of the present study mucolysis induced by the used doses of sodium bicarbonate does not significantly affect micromucosal visualization during double-contrast barium meal.

Adult↗
PubMed1978

Acute appendicitis in a child associated with prolonged appendiceal retention of barium (barium appendicitis).

An instance of acute appendicitis in a child associated with prolonged retention of barium by the appendix and formation of a barolith was presented. Previous reports have implicated barium in the etiology of appendicitis and suggest routine roentgenographic follow-up of all cases in which barium enters the appendix. Considering the frequency of this observation and the lack of an established relationship between prolonged retention of barium and appendicitis, this suggestion seems unwarranted.

Acute Disease↗
PubMed2006

Intravasation of barium sulphate at barium enema examination.

We report a case of venous intravasation of barium sulphate occurring during a routine barium enema examination for investigation of rectal bleeding. The patient suffered a cardiopulmonary arrest, but made a full recovery after organ support in intensive care. Review of radiographs from the examination showed intravasated barium in pelvic vessels. We review the literature on this rare, but serious, complication of barium enema examination and suggest measures by which intravasation can be prevented.

Aged↗
PubMed2001

[Determination of aluminium and barium in silicon-aluminium-barium alloy with internal standard by ICP-AES].

A method for the determination of aluminium and barium in silicon-aluminium-barium alloy with the internal standard by ICP-AES was studied. The method of melting sample, the interference of dissolved acid and coexisting elements and the working parameters were experimented. The sample was melted by appropriate acid, was changed into solution, the calculating lines were made by standard solution of aluminium and barium, then the concentrations of aluminium and barium were determined by ICP-AES. The linear rang, detection limits and RSD of the method were examined. The method was simple and the results were accurate.

Alloys↗
PubMed2003

Barium peritonitis--following barium enema of the proximal colon through a colostomy.

Perforation with extravasation of barium is a rare complication of contrast enema examination of the large bowel with a high associated mortality rate. The experience of performing a re-laparotomy in a patient previously exposed to barium peritonitis is even less common. We describe an elderly male patient with a Hartmann's procedure performed a year previously, presenting with peritonitis following barium enema evaluation of the proximal colon via an end descending colon stoma. Emergency laparotomy, segmental bowel resection and liberal peritoneal toilet resulted in a satisfactory outcome. The patient had a subsequent successful reversal of his Hartmann's procedure nine months later despite the presence of dense barium induced adhesions. This potentially preventable iatrogenic complication is discussed in this report, which is supplemented by a brief review of the English literature.

Aged↗