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Yeungnam Univ J Med > Volume 33(2); 2016 > Article
Yeungnam University Journal of Medicine 2016;33(2):162-165.
DOI:    Published online December 31, 2016.
Massive barium sulfate aspiration during upper gastrointestinal contrast material study in an elderly patient with dysphagia.
Hae Ryong Yun, Chang Gon Kim, Jihye Park, Yong Eun Park, Yong Il lee, Byung Woo Yoo, Kyung Soo Chung, Young Sam Kim, Joo Han Song
Division of Pulmonology, Department of Internal Medicine, The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.
Barium sulfate is an inert material used as a radiographic contrast medium during upper gastrointestinal contrast studies for evaluation of patients with dysphagia. Oral barium aspiration is an uncommon but well-reported complication of this procedure. While barium aspiration of small amounts may not cause any symptoms, massive barium aspiration can be life-threatening, particularly in elderly patients with multiple comorbidities. In this case report, we describe an elderly patient with multiple comorbidities who presented with thyrotoxicosis and dysphagia, and then died after massive barium aspiration. Despite administration of intensive medical care with ventilator support and therapeutic bronchoalveolar lavage to remove the aspirated barium, the patient died of multiple organ failure 9 days after barium aspiration. Clinicians should pay attention to elderly patients with predisposing factors for aspiration in whom upper gastrointestinal barium contrast studies are indicated, and should consider other diagnostic tools for evaluation of dysphagia in this population.
Key Words: Aspiration, Barium sulfate, Multiple organ failure
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