Hypersensitivity reactions after barium studies of the upper and lower gastrointestinal tract

One hundred sixty-seven members of the Society of Gastrointestinal Radiologists, three major commercial suppliers of barium preparations, and the Food and Drug Administration were surveyed about the incidence of hypersensitivity reactions after the administration of barium for stomach or colon examinations. The American literature was also reviewed. Twenty-seven radiologists reported 42 reactions, the companies reported 41 reactions, and the FDA documented 11 cases. An additional 12 cases were found in the literature, giving a total of 106 reactions. Of all the cases, 61% involved the skin, 8% were respiratory in nature, 8% of the patients lost consciousness, and one patient experienced an extraordinary migraine headache. Of the 42 cases reported by the radiologists, half occurred after stomach examination and half after a barium enema examination; the single-contrast technique had been used in only nine of the cases. Glucagon had been used in 11 of the 42 cases. Hypersensitivity reactions can occur after the administration of barium products and are caused by one of the many additives. These reactions are extremely unusual.     

Multiple metaplastic (hyperplastic) polyposis of the colon

Multiple metaplastic (hyperplastic) polyposis of the entire colon is an unusual entity which presents with a radiologic pattern resembling familial polyposis. It is important that the radiologist be aware of this entity and distinguish between these 2 conditions. The radiologic, pathologic, and clinical features of this condition are reviewed and an illustrative case is presented.