Abstract
The barium swallow is an important radiological investigation used for the diagnosis of upper gastrointestinal anatomical disorders like esophageal cancer, diverticulum, achalasia, foreign body, among others. Generally, it is believed to be a safe technique with rare complications, but few cases of barium sulfate aspiration have been reported in the literature with multiple complications. We are reporting a case of an elderly male who underwent esophagogram for the workup of chronic dysphagia, aspirated barium sulfate, and went into respiratory failure and circulatory shock several hours later. Moreover, we also did a systematic literature search and reviewed all available articles on aspiration of barium sulfate and its potential complications. We focused on predisposing factors for aspiration, clinical presentation, complications after aspiration, and prognosis with the aim to better understand and manage this condition.
Highlights
Severe hypoxia, acute respiratory distress syndrome (ARDS), and even death can happen in selected cases and can usually be attributed to factors including but not limited to simultaneous aspiration of gastric contents, anaphylactic reaction, and high-volume aspiration.[2,8,9,12,19,24,26]
The severity of the airflow obstruction and respiratory complications mostly depends on the amount of barium swallowed
The mortality was high among patients who had barium swallow done for the evaluation of esophageal cancer.[18,24]
Summary
An informed patient consent was obtained by the authors. The authors were actively involved in patient care and data were collected from the electronic medical records of the hospital. He had a long-standing history of coughing and choking while eating and complained about food getting stuck in his chest His vitals were stable in the emergency department and was breathing on ambient air. Chest X-ray showed contrast highlighting the tracheobronchial tree and bilateral upper lungs (Figure 2). He was managed conservatively with IV fluids and IV antibiotics. Repeat chest X-ray showed the advancement of contrast into bilateral bronchioles and alveoli with left-sided predominance (Figure 3). His respiratory status remained stable; later on, due to his other comorbidities, family opted for hospice care. Manual search using the reference list of all retrieved publications through the above-mentioned search strategy
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of Investigative Medicine High Impact Case Reports
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
