Journal of

Case Reports and Images in Surgery

 
     
Case Report
 
Barium-induced allergic appendicitis: A case report
David L. Manuel1,4, Miriam Neufeld2,5, Laura M. Piechura2,7, Qin Huang3,6, Gentian Kristo2,7
1Department of Radiology, Veterans Affairs Boston Healthcare System, Boston, MA, USA
2Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, MA, USA
3Department of Pathology, Veterans Affairs Boston Healthcare System, Boston, MA, USA
4Department of Radiology, Boston Medical Center/Boston University, Boston, MA, USA
5Department of Surgery, Boston Medical Center/Boston University, Boston, MA, USA
6Department of Pathology, Boston Medical Center/Boston University, Boston, MA, USA
7Department of Surgery, Brigham and Women’s Hospital/Harvard Medical School, Boston, MA, USA

Article ID: 100042Z12DM2017
doi:10.5348/Z12-2017-42-CR-7

Address correspondence to:
Gentian Kristo MD
Department of Surgery
Veterans Affairs Boston Healthcare System (116C)
1400 VFW Parkway, West Roxbury, Boston
MA 02132, USA

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How to cite this article:
Manuel DL, Neufeld M, Piechura LM, Huang Q, Kristo G. Barium-induced allergic appendicitis: A case report. J Case Rep Images Surg 2017;2:25–28.


ABSTRACT

Appendicitis after barium administration occurs rarely and its underlying pathology remains undetermined. We present a case where acute appendicitis presented as an allergic reaction to barium sulfate. A 55-year-old male presented with nausea and severe right lower abdomen and right groin pain seven days after a barium swallow study. Computer tomography revealed retained barium in the appendix without any signs of inflammation. The patient underwent a laparoscopic appendectomy with resolution of his symptoms. Histopathologic examination demonstrated eosinophilic infiltration of the muscularis propria, consistent with acute eosinophilic appendicitis as a result of type I hypersensitivity reaction to barium. The recognition of potential risk of barium-induced allergic appendicitis is important for timely diagnosis.

Keywords: Allergic appendicitis, Barium Sulfate, Colorectal Surgery, Eosinophilic appendicitis


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Author Contributions
David L. Manuel – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Miriam Neufeld – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Laura M. Piechura – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Qin Huang – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Gentian Kristo – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 David L. Manuel et al. This article is distributed of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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