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Diagnostic Pathology Dec 2022Barium sulfate is utilized for imaging of the gastrointestinal tract and is usually not deposited within the wall of the intestine. It is thought that mucosal injury may... (Review)
Review
BACKGROUND
Barium sulfate is utilized for imaging of the gastrointestinal tract and is usually not deposited within the wall of the intestine. It is thought that mucosal injury may allow barium sulfate to traverse the mucosa, and allow deposition to occur uncommonly. Most pathology textbooks describe the typical barium sulfate deposition pattern as small granular accumulation in macrophages, and do not describe the presence of larger rhomboid crystals. This review will summarize the clinical background, radiographic, gross, and microscopic features of barium sulfate deposition in the gastrointestinal tract. A review of the PubMed database was performed to identify all published cases of barium sulfate deposition in the gastrointestinal tract that have been confirmed by pathologic examination.
CONCLUSIONS
A review of the literature shows that the most common barium sulfate deposition pattern in the gastrointestinal tract is finely granular deposition (30 previously described cases), and less commonly large rhomboid crystals are seen (19 cases) with or without finely granular deposition. The fine granules are typically located in macrophages, while rhomboid crystals are usually extracellular. There are various methods to support that the foreign material is indeed barium sulfate, however, only a minority of studies perform ancillary testing. Scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDS) can be useful for definitive confirmation. This review emphasizes the importance of recognizing both patterns of barium sulfate deposition, and the histologic differential diagnosis.
Topics: Humans; Barium Sulfate; Gastrointestinal Tract
PubMed: 36585714
DOI: 10.1186/s13000-022-01283-8 -
Journal of Biomedical Optics Aug 2023X-ray imaging is frequently used for gastrointestinal imaging. Photoacoustic imaging (PAI) of the gastrointestinal tract is an emerging approach that has been...
SIGNIFICANCE
X-ray imaging is frequently used for gastrointestinal imaging. Photoacoustic imaging (PAI) of the gastrointestinal tract is an emerging approach that has been demonstrated for preclinical imaging of small animals. A contrast agent active in both modalities could be useful for imaging applications.
AIM
We aimed to develop a dual-modality contrast agent comprising an admixture of barium sulfate with pigments that absorb light in the second near-infrared region (NIR-II), for preclinical imaging with both x-ray and PAI modalities.
APPROACH
Eleven different NIR-II dyes were evaluated after admixture with a 40% w/v barium sulfate mixture. The resulting NIR-II absorption in the soluble fraction and in the total mixture was characterized. Proof-of-principle imaging studies in mice were carried out.
RESULTS
Pigments that produced more uniform suspensions were assessed further for photoacoustic contrast signal at a wavelength of 1064 nm that corresponds to the output of the Nd:YAG laser used. Phantom imaging studies demonstrated that the pigment-barium sulfate mixture generated imaging contrast in both x-ray and PAI modalities. The optimal pigment selected for further study was a cyanine tetrafluoroborate salt. and whole-body mouse imaging demonstrated that photoacoustic and x-ray contrast signals co-localized in the intestines for both imaging modalities.
CONCLUSION
These data demonstrate that commercially-available NIR-II pigments can simply be admixed with barium sulfate to generate a dual-modality contrast agent appropriate for small animal gastrointestinal imaging.
Topics: Mice; Animals; Barium Sulfate; Contrast Media; X-Rays; Radiography; Spectrum Analysis; Photoacoustic Techniques
PubMed: 36776721
DOI: 10.1117/1.JBO.28.8.082803 -
CA: a Cancer Journal For Clinicians 1992Colonoscopy is an accepted technique for investigation of the colon. No portion of the large bowel is inaccessible to the diagnostic and therapeutic approach by flexible... (Review)
Review
Colonoscopy is an accepted technique for investigation of the colon. No portion of the large bowel is inaccessible to the diagnostic and therapeutic approach by flexible colonoscopy. The technical aspects of instrumentation have yielded to progress, with a small television chip currently incorporated into the tip of endoscopes transmitting an excellent image of the colon. Primary colonoscopy is being performed for selected indications, and, as facility with the technique increases, there will be a greater tendency for the performance of primary colonoscopy. Interruption of the adenoma-carcinoma sequence by techniques of snare-polypectomy may serve to markedly decrease the incidence of colon cancer over the next generation.
Topics: Barium Sulfate; Colonic Diseases; Colonoscopes; Colonoscopy; Enema; Forecasting; Humans
PubMed: 1393743
DOI: 10.3322/canjclin.42.6.350 -
The Journal of Veterinary Medical... May 2014Barium peritonitis is extremely rare, but is difficult to treat and may be life-threatening. Barium suspension leakage from the gastrointestinal tract into the abdominal... (Review)
Review
Barium peritonitis is extremely rare, but is difficult to treat and may be life-threatening. Barium suspension leakage from the gastrointestinal tract into the abdominal cavity has a time-dependent and synergistically deleterious effect in patients who have generalized bacterial peritonitis. The severity of barium peritonitis is dependent on the quantity of barium in the abdominal cavity. Barium sulfate leakage results in hypovolemia and hypoproteinemia by worsening the exudation of extracellular fluid and albumin. Abdominal fluid analysis is a useful and efficient method to diagnose barium peritonitis. Serial radiographs may not be a reliable or timely diagnostic technique. Initial aggressive fluid resuscitation and empirical broad-spectrum antibiotic treatment should be instituted promptly, followed quickly by celiotomy. During exploratory surgical intervention, copious irrigation and direct wiping with gauze are employed to remove as much barium as possible. Omentectomy should be considered when needed to expedite barium removal. Despite aggressive medical and surgical treatments, postoperative prognosis is guarded to poor due to complications, such as acute vascular shock, sepsis, diffuse peritonitis, hypoproteninemia, electrolyte imbalance, cardiac arrest, small bowel obstruction related to progression of granulomas and adhesions in the abdominal cavity. Therefore, intensive postoperative monitoring and prompt intervention are necessary to maximize chances for a positive outcome. For those that do survive, small bowel obstruction is a potential consequence due to progression of abdominal adhesions.
Topics: Animals; Barium Sulfate; Cats; Digestive System Diseases; Dogs; Intestinal Perforation; Omentum; Peritonitis; Prognosis
PubMed: 24430662
DOI: 10.1292/jvms.13-0220 -
Scientific Reports Dec 2023Barium sulfate and iohexol are commonly used as contrast agents for videofluoroscopic swallowing study (VFSS). This study compared their usefulness as contrast agents in... (Randomized Controlled Trial)
Randomized Controlled Trial
Barium sulfate and iohexol are commonly used as contrast agents for videofluoroscopic swallowing study (VFSS). This study compared their usefulness as contrast agents in visualizing components of swallowing predictable of subsequent pneumonia and unintentional weight loss after VFSS. This was a randomized, controlled, crossover trial. The two contrast agents were alternately used in the same participants, and the order in which the contrast agent was tested first was randomly assigned. After VFSS, we followed the participants for 3 months and the association between VFSS findings of each contrast agent and the subsequent pneumonia and unintentional weight loss were analyzed. A total of 30 participants were included in the analysis. We recorded 11 cases of subsequent pneumonia and 13 of unintentional weight loss. Regarding the risk of subsequent pneumonia after VFSS, only the oral transit time and number of swallows tested with barium sulfate indicated significant differences between participants with and without subsequent pneumonia. For unintentional weight loss, oral transit time and pharyngeal wall coating after swallowing tested with barium sulfate, as well as oral transit time, nasal penetration, residue in the valleculae, PAS scores, and number of swallows when testing with iohexol demonstrated significant differences between those with and without unintentional weight loss.
Topics: Humans; Barium Sulfate; Contrast Media; Deglutition; Deglutition Disorders; Fluoroscopy; Iohexol; Pneumonia; Video Recording; Weight Loss; Cross-Over Studies
PubMed: 38057481
DOI: 10.1038/s41598-023-46297-4 -
Current Opinion in Otolaryngology &... Dec 2020The modified barium swallow study (MBSS) is an X-ray examination of swallowing used to detect the presence and type impairment, aspiration risk, and to develop... (Review)
Review
PURPOSE OF REVIEW
The modified barium swallow study (MBSS) is an X-ray examination of swallowing used to detect the presence and type impairment, aspiration risk, and to develop intervention plans. In this review, we will cover the use of ionizing radiation in MBSSs and review recent literature concerning radiation exposure and cancer risks to patients undergoing MBSSs. Lastly, we will discuss the clinical implications of these findings.
RECENT FINDINGS
Recent literature confirms that the MBSS is a low-dose examination and that reducing pulse rate negatively impacts diagnostic accuracy. Importantly, cancer risks to adults undergoing MBSSs were also reported to be low.
SUMMARY
An adult undergoing MBSS using a standardized, valid protocol, like the Modified Barium Swallow Impairment Profile (MBSImP), has low-radiation exposure and very low associated cancer risks. MBSSs should be used whenever relevant to adult patient care without undue concern regarding radiation exposure. Children also have low radiation exposure from MBSSs; however, cancer risks from that exposure remain unknown. Best practices in radiation safety must always be followed. Reducing pulse rates in the adult or pediatric population to reduce radiation exposure is not a valid strategy because of the resulting reduction in diagnostic accuracy.
Topics: Barium Sulfate; Deglutition Disorders; Fluoroscopy; Humans; Neoplasms, Radiation-Induced; Radiation Exposure; Risk
PubMed: 33027137
DOI: 10.1097/MOO.0000000000000665 -
Particle and Fibre Toxicology Oct 2014Nanoparticulate barium sulfate has potential novel applications and wide use in the polymer and paint industries. A short-term inhalation study on barium sulfate... (Comparative Study)
Comparative Study
BACKGROUND
Nanoparticulate barium sulfate has potential novel applications and wide use in the polymer and paint industries. A short-term inhalation study on barium sulfate nanoparticles (BaSO₄ NPs) was previously published [Part Fibre Toxicol 11:16, 2014]. We performed comprehensive biokinetic studies of ¹³¹BaSO₄ NPs administered via different routes and of acute and subchronic pulmonary responses to instilled or inhaled BaSO₄ in rats.
METHODS
We compared the tissue distribution of ¹³¹Ba over 28 days after intratracheal (IT) instillation, and over 7 days after gavage and intravenous (IV) injection of ¹³¹BaSO₄. Rats were exposed to 50 mg/m³ BaSO₄ aerosol for 4 or 13 weeks (6 h/day, 5 consecutive days/week), and then gross and histopathologic, blood and bronchoalveolar lavage (BAL) fluid analyses were performed. BAL fluid from instilled rats was also analyzed.
RESULTS
Inhaled BaSO₄ NPs showed no toxicity after 4-week exposure, but a slight neutrophil increase in BAL after 13-week exposure was observed. Lung burden of inhaled BaSO₄ NPs after 4-week exposure (0.84 ± 0.18 mg/lung) decreased by 95% over 34 days. Instilled BaSO₄ NPs caused dose-dependent inflammatory responses in the lungs. Instilled BaSO₄ NPs (0.28 mg/lung) was cleared with a half-life of ≈ 9.6 days. Translocated ¹³¹Ba from the lungs was predominantly found in the bone (29%). Only 0.15% of gavaged dose was detected in all organs at 7 days. IV-injected ¹³¹BaSO₄ NPs were predominantly localized in the liver, spleen, lungs and bone at 2 hours, but redistributed from the liver to bone over time. Fecal excretion was the dominant elimination pathway for all three routes of exposure.
CONCLUSIONS
Pulmonary exposure to instilled BaSO₄ NPs caused dose-dependent lung injury and inflammation. Four-week and 13-week inhalation exposures to a high concentration (50 mg/m³) of BaSO₄ NPs elicited minimal pulmonary response and no systemic effects. Instilled and inhaled BaSO₄ NPs were cleared quickly yet resulted in higher tissue retention than when ingested. Particle dissolution is a likely mechanism. Injected BaSO₄ NPs localized in the reticuloendothelial organs and redistributed to the bone over time. BaSO₄ NP exhibited lower toxicity and biopersistence in the lungs compared to other poorly soluble NPs such as CeO₂ and TiO₂.
Topics: Administration, Oral; Air Pollutants; Animals; Barium Radioisotopes; Barium Sulfate; Dose-Response Relationship, Drug; Female; Half-Life; Inhalation Exposure; Injections, Intravenous; Intestinal Absorption; Intestinal Elimination; Lung; Male; Metal Nanoparticles; Pneumonia; Rats, Inbred WKY; Respiratory Mucosa; Respiratory Tract Absorption; Solubility; Tissue Distribution; Toxicity Tests, Acute; Toxicity Tests, Subchronic; Toxicokinetics
PubMed: 25331813
DOI: 10.1186/s12989-014-0055-3 -
Gut Dec 1963The term ;right-sided colitis' has been used to describe a lesion in which the right half of the colon shows maximal inflammatory changes; although the terminal ileum is...
The term ;right-sided colitis' has been used to describe a lesion in which the right half of the colon shows maximal inflammatory changes; although the terminal ileum is always involved, the rectum is normal or shows minimal inflammatory changes. Some of these cases appear to be of atypical Crohn's disease, whilst the others resemble chronic ulcerative colitis. The high incidence of Jewish people in this series suggests a racial tendency towards this distribution of the inflammatory change. The right-sided nature of the lesion has led to unnecessarily prolonged medical treatment, to right hemicolectomy, and to ileorectal anastomosis. The results of such procedures have been disappointing, all the more so because the rectum was almost normal and hence would seem ideally suited for ileorectal anastomosis. These patients have progressed very well with ileostomy.
Topics: Anastomosis, Surgical; Barium Sulfate; Colectomy; Colitis; Colitis, Ulcerative; Crohn Disease; Enteritis; Humans; Ileostomy; Ileum; Jews; Pathology; Radiography; Rectum; Surgical Procedures, Operative
PubMed: 14084742
DOI: 10.1136/gut.4.4.316 -
Molecules (Basel, Switzerland) Jan 2023In this paper, methyl glycine diacetic acid (MGDA) was found to have great influence on the morphology and particle size of barium sulfate. The effects of additive,...
In this paper, methyl glycine diacetic acid (MGDA) was found to have great influence on the morphology and particle size of barium sulfate. The effects of additive, concentration, value of pH and reaction temperature on the morphology and particle size of barium sulfate were studied in detail. The results show that the concentration of reactant and temperature have little effect on the particle size of barium sulfate. However, the pH conditions of the solution and the dosage of MGDA can apparently affect the particle size distribution of barium sulfate. The particle size of barium sulfate particles increases and the morphology changes from polyhedral to rice-shaped with the decreasing of the dosage of MGDA. In solution with higher pH, smaller and rice-shaped barium sulfate was obtained. To investigate the interacting mechanism of MGDA, the binding energy between MGDA and barium sulfate surface was calculated. It was found that the larger absolute value of the binding energy would result in stronger growth inhibition on the crystal face. Finally, the experimental data and theoretical calculations were combined to elucidate the interacting mechanism of the additive on the morphology and particle size of barium sulfate.
Topics: Barium Sulfate; Particle Size; Temperature; Surface Properties
PubMed: 36677780
DOI: 10.3390/molecules28020726 -
Paediatric Respiratory Reviews Jun 2016The current available literature evaluating feeding difficulties in children with esophageal atresia was reviewed. The published literature was searched through PubMed... (Review)
Review
The current available literature evaluating feeding difficulties in children with esophageal atresia was reviewed. The published literature was searched through PubMed using a pre-defined search strategy. Feeding difficulties are commonly encountered in children and adults with repaired esophageal atresia [EA]. The mechanism for abnormal feeding includes both esophageal and oropharyngeal dysphagia. Esophageal dysphagia is commonly reported in patients with EA and causes include dysmotility, anatomic lesions, esophageal outlet obstruction and esophageal inflammation. Endoscopic evaluation, esophageal manometry and esophograms can be useful studies to evaluate for causes of esophageal dysphagia. Oropharyngeal dysfunction and aspiration are also important mechanisms for feeding difficulties in patients with EA. These patients often present with respiratory symptoms. Videofluoroscopic swallow study, salivagram, fiberoptic endoscopic evaluation of swallowing and high-resolution manometry can all be helpful tools to identify aspiration. Once diagnosed, management goals include reduction of aspiration during swallowing, reducing full column reflux into the oropharynx and continuation of oral feeding to maintain skills. We review specific strategies which can be used to reduce aspiration of gastric contents, including thickening feeds, changing feeding schedule, switching formula, trialing transpyloric feeds and fundoplication.
Topics: Adult; Barium Sulfate; Child; Contrast Media; Deglutition Disorders; Esophageal Atresia; Esophagoscopy; Humans; Manometry; Nutritional Support
PubMed: 26164203
DOI: 10.1016/j.prrv.2015.06.002