ABSTRACT
A case in which inspissated barium was retained and produced sigmoid obstruction after one year is described. The patient was elderly and myxoedematous. Prolonged retention of barium producing a bowel obstruction requiring surgery is a rare complication and, to our knowledge, is only the second case described in which the symptoms of obstruction appeared so late after the examination.
Subject(s)
Barium Sulfate/adverse effects , Colonic Diseases/chemically induced , Contrast Media/adverse effects , Intestinal Obstruction/chemically induced , Aged , Colonic Diseases/surgery , Female , Humans , Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/surgery , Radiography , Treatment OutcomeABSTRACT
RATIONALE AND OBJECTIVES: Enteroclysis (small-bowel enema) involves the introduction of a large amount of fluid into the small bowel, through a tube, producing small bowel distention. A study was done to determine the incidence of any electrocardiographic changes during enteroclysis with Holter monitoring. METHODS: Continuous electrocardiographic monitoring and 12-lead electrocardiograms were performed in 30 elderly patients undergoing enteroclysis and in 30 control subjects undergoing routine chest, bone, and upper gastrointestinal small bowel follow-up studies. Two channel qualitative and quantitative electrocardiographic analysis was performed by a computerized nontriggered template system. Arrhythmias, change in cardiac axis, conduction defects, pauses, ST segment changes, and ectopics were sought. RESULTS: Increased sympathetic tone resulting in increased heart rate and transient atrial and ventricular ectopics was frequent during enteroclysis compared with the control group. In one patient ventricular tachycardia developed, and two patients had diminished heart rate, but this was attributed to preexisting heart disease and concurrent medication. CONCLUSION: Transient, nonhazardous cardiac arrhythmias are encountered during enteroclysis in elderly patients. These arrhythmias may be attributed to the preexisting heart disease, fear, and anxiety during intubation, or increased sympathetic tone from the enteric loop distention.
Subject(s)
Arrhythmias, Cardiac/etiology , Electrocardiography, Ambulatory , Enema/adverse effects , Intestine, Small , Aged , Arrhythmias, Cardiac/physiopathology , Female , Follow-Up Studies , Heart Rate/physiology , Humans , Incidence , Male , Risk FactorsABSTRACT
This is the first case reported of combined hiatus hernia of the stomach and herniation of the splenic flexure of the colon through the oesophageal hiatus. It was associated with unusual clinical and electrocardiographic findings. We postulate that these were the result of an increase in intrathoracic pressure induced by the herniating structures.
