TY - JOUR TT - Fatal Rectal Perforation Following Double Contrast Barium Enema AU - Akay, Serhat AU - Akay, Huriye AU - Yeşil, Mustafa PY - 2012 DA - October JF - Journal of Emergency Medicine Case Reports PB - Acil Tıp Uzmanları Derneği WT - DergiPark SN - 2149-9934 SP - 113 EP - 115 VL - 3 IS - 4 KW - Karın ağrısı KW - radyoloji KW - intestinal perforasyon KW - rektum KW - retropnömoperitonium N2 - Double-contrast barium enema (DCBE) is a widely used diagnostic tool for colorectal disorders, providing a relatively cheap and less invasive alternative to invasive procedures such as colonoscopy. Complications due to DCBE can be fatal in a small number of cases. Rectal perforations to the intra-peritoneal or retro-peritoneal space are the most severe and life-threatening complications where immediate diagnosis and treatment are essential. We report the case of a 72-year-old male admitted to the emergency department with dyspnea, altered mental status and swelling in the neck 15 minutes after DCBE. Upright chest X-ray revealed sub-diaphragmatic air with subcutaneous emphysema, and computed tomography revealed air in the deep neck tissue and abdominal cavity, accompanied by pneumothorax and pneumomediastinum. This case demonstrates the importance of chest pain, neck swelling and neurological symptoms after DCBE as signs of possible serious complications that should alert emergency physicians CR - Himmelmann W. Ueber. die Perforation im Bereich des Magen-Darm- traktus bei und nach der Rontgenbreipassage. Munch Med Woc- henschr 1932; 79: 1567-71 CR - Vora P, Chapman A. Complications from radiographer-performed do- uble contrast barium enemas. Clin Radiol 2004; 59: 364-8. [CrossRef] CR - de Feiter PW, Soeters PB, Dejong CH. Rectal perforations after barium enema: a review. Dis Colon Rectum 2006; 49: 261-71. [CrossRef] CR - Peterson N, Rohrmann CA Jr, Lennard ES. Diagnosis and treatment of retroperitoneal perforation complicating the double-contrast barium- enema examination. Radiology 1982; 144: 249-52. CR - Ault GW. Perforation of the rectum with enema tips. Transactions of the Annual Meeting of the American Proctologic Society 1939; 40: 203-11. CR - De Feiter PW, Soeters PB, Dejong CH. Biphasic development of an int- raperitoneal rectum perforation: a rare but serious complication after barium enema. Int J Colorectal Dis 2007; 22: 719-21. [CrossRef] CR - Weiss Y, Grunberger P, Aronowitz S. Asymptomatic rectal perforation with retroperitoneal emphysema. Dis Colon Rectum 1981; 24: 545-7 [CrossRef]. CR - Tadros S, Watters JM. Retroperitoneal perforation of the rectum during barium enema examination. Can J Surg 1988; 31: 49-50. CR - Terranova O, Meneghello A, Battocchio F, Martella B, Celi D, Nistri R. Per- forations of the extraperitoneal rectum during barium enema. Int Surg 1989; 74: 13-6. CR - Hakim NS, Sarr MG, Bender CE, Nivatvongs S. Management of barium enema-induced colorectal perforation. Am Surg 1992; 58: 673-6. UR - https://dergipark.org.tr/tr/pub/jemcr/issue//535401 L1 - https://dergipark.org.tr/tr/download/article-file/663081 ER -