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

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 wh o 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 neurolo gic and cardiovascular manifestations that rapidly progressed and led to de ath a few days later. Laboratory findings demonstrated elevated levels of b arium in the blood and cerobrospinal fluid. The most likely mechanism of po isoning was progressive intravasation of barium due to stasis of contrast m aterial related to intestinal obstruction. (C) 1999 Elsevier Science Irelan d Ltd. All rights reserved.