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Pneumoperitoneum Following Double Contrast Enema

St. Thomas' Hospital, London, S.E.1

This excerpt was created in the absence of an abstract.

Intraperitoneal or extraperitoneal extravasation of barium following rupture of the colon during the filling stage of barium enema examination has been described by many authors. The literature to date was summarised by Samuel and Pyle in 1960. In the large majority of cases, the perforation is accounted for by injury to the rectum or colon by the enema tube or balloon, or by the presence of gross pathology in the colon, usually carcinoma, diverticulitis, or ulcerative colitis. Perforation is much more frequent when the enema fluid is administered through a colostomy, as the colon is more liable to injury by the enema tube than is the rectum. Whatever the cause, perforation with escape of barium is a serious complication, the mortality being in the region of 50 per cent in most series. The ill effects of the extravated barium are due to bacterial contamination in most cases, but absorption of tannic acid, if this is used, may be a contributory factor, (Portin and Bernhoft, 1963).