Barium peritonitis: a rare complication of upper gastrointestinal contrast investigation

Contrast examination of the gastrointestinal tract is rarely complicated by perforation. The colon and rectum are most commonly affected, with many perforations limited to the retroperitoneum. Generalised peritonitis is therefore rare, but is life-threatening and difficult to treat. We present two analogous cases in which extravasation of barium sulphate complicated contrast meal investigation. These cases illustrate important aspects in the management of this unusual occurrence.