Barium Intravasation Into Portal Venous System During Barium Enema Examination

BARIUM enema examination has had a very low complication rate, approximately two in 10,000 studies. During a 20-year period at the Columbia Presbyterian Hospital (New York), Seaman and Wells1found only 13 examples of perforation of the colon during barium enema examination. We have recently encountered a unique complication of the barium enema, one that has been reported only once before, to our knowledge, ie, intravasation of barium into the portal venous system. This occurred during a barium enema examination of a patient with ulcerative colitis. Report of a Case A 36-year-old woman had had upper gastrointestinal bleeding, thought to be from a duodenal ulcer, in 1970 and 1972; both episodes were controlled medically. The patient had a history of chronic alcoholism. Approximately one month before admission, she experienced weakness, anorexia, and nausea, and passed several black stools. She had also lost 4.5 kg (10 lb) during this month.