Fatal poisoning due to intravasation after oral administration of barium sulfate for contrast radiography

• Published in: Forensic science international Vol. 106; no. 2; pp. 109 - 113
• Main Authors: PELISSIER-ALICOT, A.-L, LEONETTI, G, CHAMPSAUR, P, ALLAIN, P, MAURAS, Y, BOTTA, A
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier 06.12.1999; Elsevier Limited
• Subjects: Abdomen; Acute Disease; Administration, Oral; Barite; Barium; Barium sulfate; Barium Sulfate - analysis; Barium Sulfate - poisoning; Biological and medical sciences; Cerebrospinal fluid; Cholecystectomy; Cholelithiasis - diagnostic imaging; Colonic Diseases - complications; Coma - etiology; Computed tomography; Contrast Media - analysis; Contrast Media - poisoning; Drug intoxications. Doping; Fatal Outcome; Female; Forensic medicine; Gastrointestinal tract; Granulomas; Humans; Intestinal Obstruction - complications; Intoxication; Medical sciences; Middle Aged; Oral administration; Pancreatitis - diagnostic imaging; Pharmacology. Drug treatments; Poisoning; Public health. Hygiene; Public health. Hygiene-occupational medicine; Radiography; Rectum; Scientific imaging; Seizures - etiology; Shock - etiology; Sulfates; Tomography, X-Ray Computed; Human; Iatrogenic; Radiodiagnosis; Toxicity; Postmortem; Oral administration; Radiologic investigation; Forensic aspect; Blood; Barium sulfate; Ingestion; Case study; Radiography; Intestinal stasis; Complication; Female; Poisoning; Computerized axial tomography; Diagnosis; Elderly; Contrast media
• ISSN: 0379-0738; 1872-6283
• DOI: 10.1016/S0379-0738(99)00154-1

A fatal poisoning after oral administration of barium sulfate for contrast radiography is reported. Barium sulfate is an insoluble salt and therefore is almost nontoxic. The case described here involves a 61-year-old woman who underwent two CT scans of the digestive tract with oral administration of barium sulfate during a surgical procedure. Within several hours after the first barium swallow examination the patient presented nonspecific neurologic and cardiovascular manifestations that rapidly progressed and led to death a few days later. Laboratory findings demonstrated elevated levels of barium in the blood and cerebrospinal fluid. The most likely mechanism of poisoning was progressive intravasation of barium due to stasis of contrast material related to intestinal obstruction.