A Barium Swallow Study Leading to an Incidental Finding on a Screening Colonoscopy

Patricia Guzman Rojas,Glenn Speth,Chirin Orabi

doi:10.7759/cureus.1920

Abstract

Barolith is a mixture of firm feces with barium sulfate, and a frequent cause of obstruction of the appendiceal lumen that can result in appendicitis. Nonetheless, some other complications like aspiration, allergic reaction, and bowel obstruction have also been reported. We present the case of a 71-year-old man with a history of amyotrophic lateral sclerosis (ALS), who came to the gastroenterology clinic complaining of intermittent loose stools and dysphagia to solids for the past months. The patient underwent a barium swallow study six days prior and was completely normal. A colonoscopy was done showing normal appearing mucosa, with a whitish foreign object found on the appendiceal orifice. Removal of the barolith was done by means of a biopsy forceps.Our patient did not have any signs or symptoms of appendicitis prior to the procedure, and the successful removal of the barolith was achieved. Elderly patients, and patients with decreased gastrointestinal (GI) transit, could be a population at risk for barium retention/appendicitis; for this reason, more research studies should be done to assess possible preventive treatments.

Highlights

Barium studies are diagnostic tests that are widely performed in the United States and have currently replaced several invasive procedures
We present the case of a 71-year-old man with a history of amyotrophic lateral sclerosis (ALS), who came to the gastroenterology clinic complaining of intermittent loose stools and dysphagia to solids for the past months
There are mainly three types of studies: barium enema, small-bowel follow through, and barium swallow. These diagnostic tools provide an accurate evaluation of the anatomy of the gastroenterology (GI) tract, there are several complications associated with them. We report this case to elucidate pertinent images related to a barium swallow test, and we provide pertinent literature research about the post-procedure complications

Summary

Introduction

Barium studies are diagnostic tests that are widely performed in the United States and have currently replaced several invasive procedures. There are mainly three types of studies: barium enema, small-bowel follow through, and barium swallow These diagnostic tools provide an accurate evaluation of the anatomy of the gastroenterology (GI) tract, there are several complications associated with them. We report this case to elucidate pertinent images related to a barium swallow test, and we provide pertinent literature research about the post-procedure complications. The patient reported persistent symptoms, despite the abovementioned treatment He complained of dysphagia to solids and liquids and felt that it was likely related to his ALS. There weren't any reported complications after the procedure (Figure 3)

Discussion

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Conclusions

Disclosures