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Case of the Week 633


What is the most likely diagnosis?

  • 48 year-old with abdominal pain following a test



Maximum Intensity Projection Image (MIP) from a CT Urogram

  1. Meconium peritonitis
  2. Multiple gunshot wounds
  3. Thorotrast administration
  4. Extraluminal barium
  5. Old TB

Additional Images-None

 

Additional Images

 

 

None


Answer:

4. Extraluminal barium

More (Click Discussion Tab)

 

 

Thoracoplasty for TB

Barium Perforation into the Peritoneal Cavity

General Considerations

  • Barium sulfate is used as a contrast agent for, amongst other things, barium enema examinations
  • It is inert, radiopaque and provides excellent anatomical detail
  • On very rare occasions, a perforation may occur allowing the administered barium to leak into the peritoneal cavity
  • Barium peritonitis may occur from an inflammatory reaction
    • Intestinal content, e.g. fecal material, which also spills into the peritoneal cavity at the same time may play a role in producing sepsis
    • “Sterile” barium contamination will still cause peritonitis, but it may not be accompanied by the same degree of sepsis

MORE . . .


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This Week

48 year-old with abdominal pain following a test
 
 



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LearningRadiology.com
is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.