Endoscopic Removal of Impacted Barium Stools Using a Snare and a Long Hood: A Rare Complication Following Upper Gastrointestinal Barium X-ray Radiography (With Video).

Abstract

Barium sulfate is widely used as a radiographic contrast medium in upper gastrointestinal barium X-ray radiography for cancer screening in Japan. Although generally considered safe, rare complications such as bowel obstruction due to impacted barium stools can occur. We report the case of a healthy 41-year-old woman who developed colonic obstruction following upper gastrointestinal barium X-ray radiography. Endoscopic treatment was attempted using a snare and a long hood to fragment and remove the barium mass. The impacted stools were successfully removed endoscopically, and there were no serious complications such as bowel perforation or generalized peritonitis that would require surgery. This case demonstrates that endoscopic removal can be an effective and less invasive treatment option for barium impaction, which carries a risk of requiring surgical intervention. Although patients are usually advised to hydrate and take laxatives after the examination, this case highlights the importance of ensuring that patients fully understand the potential risk and the need to seek prompt medical attention.