雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Barium Granuloma, Report of Two Cases I. Sekine 1 , R. Takahira 1 , I. Sato 2 , K. Fukushima 2 , S. Kitazato 2 , T. Shimoyama 2 , Y. Uchida 2 , H. Oota 3 1Department of Pathology, Atomic Disease Institute, Nagasaki University, School of Medicine 2The First Department of Surgery, Nagasaki University, School of Medicine 3Department of Surgery, Nagasaki Saiseikai Hospital pp.235-240
Published Date 1982/2/25
DOI https://doi.org/10.11477/mf.1403108775
  • Abstract
  • Look Inside

 Barium granuloma of the rectum is one of the rare complications of the barium enema, which possibly results from laceration of the rectal mucosa by the enema tip. In Japan, only four previous cases have been reported to date. Two additional cases are reported here.

 Case 1. A 75-year-old woman was admitted to the hospital, with complaint of lumbago, and took the barium enema using a balloon on September 1, 1978. The results of the barium enema were unsatisfactory, and after the barium enema the patient complained of blood discharge from the anus. On September 6, the endoscopy showed a Borrmann 3 type-like lesion in the rectum. On September 18, a resection of the rectum was performed. There was an irregularly shaped ulceration (2.5×1.5 cm) at 1.5 cm from the dental line. Histologically the accumulation of histiocytes accompanied with the foreign body type giant cells was seen through the total rectal wall, especially in the submucosa, which phagotized fine granular crystals, bright yellow green in colon (barium sulfate). The crystals were not stained with Kossa's method for calcium, Prussian blue stain for iron and Masson's silver method or melanin, and were doubly reflactile with polarized light. A chronic inflammatory reaction was seen, but it was mild. The accumulation of the barium was confirmed by the ultrasoft x-ray in the embedded specimen.

 Case 2. A 64-year-old woman had not taken the barium enema. She took the barium erema on August 21 bacause of diarrhea and abdominal pain. On August 28, endoscopically a Borrmann 2 type-like lesion was seen in the rectum. On September 9, several biopsy specimens were taken and the lesion was diagnosed as barium granuloma. The roentgenograms of the abdomen taken on September 24 and on October 24 showed the residual barium in the rectal wall.

 These two cases were thought to have developed the lesions after the first barium enema, and were histologically diagnosed at eighteenth day and twenty-first day after the barium enema, respectively.

 It is important to keep the followings in mind so as not to take a barium granuloma for a carcinoma: (1) history of the barium enema, (2) confirmation of the residual barium in the rectal wall by the simple roentgenogram of the abdomen, and (3) histological proof of the barium by biopsy.


Copyright © 1982, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

関連文献

もっと見る

文献を共有