Abstract

Tannic acid has been added to barium sulfate for evaluation of the colon and distal small bowel by radiologists for a number of years. More recently it has been combined with the cleansing enemas given prior to the barium-enema examination. Several groups have recently presented strong evidence to implicate this practice as a factor in some deaths due to liver toxicity (1, 2). Reports of deaths attributed to the addition of tannic acid to enemas are all the more disturbing when considered in the light of its known toxicity. Wells et al. (3) implicated tannic acid applied topically in the treatment of burns as the cause of liver necrosis in these patients. They further extended this premise to rats in which they were able to produce liver necrosis by subcutaneous injections of tannic acid. Baker et al. (4) verified these findings and were able to produce hepatic damage with tannic acid applied to large denuded surfaces. Tannic acid toxicity to the liver in the concentrations studied along with the ability ...

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