Delayed Stercoral Colitis Secondary to Retained Barium Contrast 5 Months After a Fluoroscopic Study
Sandeepa Dadigamuwage, George Davies, Rhys Leary, Vimarshini Samarakoon, Sreeranj Madathiparambil, Riya Babu, Sai Debbati, Muhammad AbdalkoddusABSTRACT
Retained barium contrast can rarely inspissate into a barolith and present months after a fluoroscopic study, mimicking a metallic foreign body on computed tomography (CT). We report a 51-year-old woman with abdominal pain, nausea, bloating, and 3 days of absolute constipation. CT demonstrated a 6.5 cm intraluminal colonic mass with proximal distension and no perforation. Repeat CT showed distal migration with inflammatory change consistent with stercoral colitis, later linked to a barium swallow 5 months earlier. Flexible sigmoidoscopy confirmed an impacted barolith with stercoral mucosal injury; extraction was abandoned due to perforation risk. Twice-daily macrogol and phosphate enemas achieved passage, with complete radiographic resolution and asymptomatic follow-up.