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Severe barium sulphate aspiration: a report of two cases and review of the literature

Constantine Katsanoulas ; Intensive Care Unit, Hippokration General Hospital of Thessaloniki, Mantineias str. 85, GR-54248, Thessaloniki, Greece
Marija Passakiotou ; Intensive Care Unit, Hippokration General Hospital of Thessaloniki, Mantineias str. 85, GR-54248, Thessaloniki, Greece
Eleni Mouloudi ; Intensive Care Unit, Hippokration General Hospital of Thessaloniki, Mantineias str. 85, GR-54248, Thessaloniki, Greece
Vassiliki Georgopoulou ; 1st Radiology Department, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
Nikoletta Gritsi-Gerogianni ; Intensive Care Unit, Hippokration General Hospital of Thessaloniki, Mantineias str. 85, GR-54248, Thessaloniki, Greece

Fulltext: english, pdf (94 KB) pages 25-28 downloads: 893* cite
APA 6th Edition
Katsanoulas, C., Passakiotou, M., Mouloudi, E., Georgopoulou, V. & Gritsi-Gerogianni, N. (2007). Severe barium sulphate aspiration: a report of two cases and review of the literature. Signa vitae, 2 (1), 25-28. Retrieved from https://hrcak.srce.hr/11967
MLA 8th Edition
Katsanoulas, Constantine, et al. "Severe barium sulphate aspiration: a report of two cases and review of the literature." Signa vitae, vol. 2, no. 1, 2007, pp. 25-28. https://hrcak.srce.hr/11967. Accessed 23 Nov. 2020.
Chicago 17th Edition
Katsanoulas, Constantine, Marija Passakiotou, Eleni Mouloudi, Vassiliki Georgopoulou and Nikoletta Gritsi-Gerogianni. "Severe barium sulphate aspiration: a report of two cases and review of the literature." Signa vitae 2, no. 1 (2007): 25-28. https://hrcak.srce.hr/11967
Harvard
Katsanoulas, C., et al. (2007). 'Severe barium sulphate aspiration: a report of two cases and review of the literature', Signa vitae, 2(1), pp. 25-28. Available at: https://hrcak.srce.hr/11967 (Accessed 23 November 2020)
Vancouver
Katsanoulas C, Passakiotou M, Mouloudi E, Georgopoulou V, Gritsi-Gerogianni N. Severe barium sulphate aspiration: a report of two cases and review of the literature. Signa vitae [Internet]. 2007 [cited 2020 November 23];2(1):25-28. Available from: https://hrcak.srce.hr/11967
IEEE
C. Katsanoulas, M. Passakiotou, E. Mouloudi, V. Georgopoulou and N. Gritsi-Gerogianni, "Severe barium sulphate aspiration: a report of two cases and review of the literature", Signa vitae, vol.2, no. 1, pp. 25-28, 2007. [Online]. Available: https://hrcak.srce.hr/11967. [Accessed: 23 November 2020]

Abstracts
Aspiration of barium sulphate is a well-recognized complication, occurring accidentally during examinations of the upper gastrointestinal system using contrast media. Rarely, large amounts of barium sulphate are inadvertently aspirated into the lung. Certain conditions affecting the anatomical and functional integrity of the oropharynx and oesophagus suggest predisposing factors. Aspiration of barium sulphate is not expected to cause severe lung injury due to its relatively non-irritant matter. On the other hand, acute inflammation or even death attributed either to high or low density preparations of barium sulphate, have been reported.
We present two patients, both with a history of schizophrenia, who developed acute respiratory failure requiring mechanical ventilation, following aspiration of large amounts of barium, during an upper gastrointestinal radiographic contrast study. One patient died following massive aspiration which led to multiple organ dysfunction syndrome, while the other, although sub- acutely complicated by pneumonia, was successfully treated.
Beside presentation of cases, several aspects of investigation, differential diagnosis, treatment and prevention are discussed. Complications of barium sulphate aspiration depend upon the density and quantity of the aspirated solution, the extent of tracheobronchial distribution and the general physical condition of the patient. In severe cases, early treatment and close follow up with high-resolution computed tomography are mandatory to prevent progression towards fibrosis. Patients with psychiatric disorders, apart from other conditions predisposing to aspiration, should be dealt with particular caution, when performing the above-mentioned procedures.

Keywords
barium; barium sulphate; aspiration pneumonia; lung CT; lung scintigraphy

Hrčak ID: 11967

URI
https://hrcak.srce.hr/11967

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