Barium Sulfate (Local)


VA CLASSIFICATION
Primary: DX101

{27}Commonly used brand name(s): ACB; Anatrast; Baricon; Baro-cat; Barobag; Barosperse; E-Z-AC; E-Z-CAT; E-Z-Disk; E-Z-Dose; E-Z-HD; E-Z-Jug; E-Z-Paque; E-Z-Paque Enema; E-Z-Paque Liquid; E-Z-Paste Esophageal Cream; Enecat; Entero-H; Entrobar; Epi-C; Esobar; Esopho-CAT Esophageal Cream; Esophotrast Esophageal Cream; EvacuPaste; Exacta I; Exacta II; Flo-Coat; Gil-Paque; HD 200 Plus; HD 85; Liqui-Jug; Liquid Barosperse; Liquid HD; Liquipake; Maxibar; Medebag; Medebar Plus; Polibar; Polibar Flavored; Polibar Liquid; Polibar Plus; Polibar Rapide; Prepcat; Probar; Readi-CAT; Readi-CAT 2; Readi-CAT Unflavored; Recto-Barium; Sol-O-Pake; Sol-O-Pake Liquid; Tomocat; Tomocat 1000; Tonojug 2000; Tonopaque; Ultra-R; Unibar-100; mede-SCAN.

Note: For a listing of dosage forms and brand names by country availability, see Dosage Forms section(s).



Category:


Diagnostic aid, radiopaque (gastrointestinal disorders)—

Indications

Accepted

Radiography, gastrointestinal—Oral or rectal barium sulfate suspension, and the oral tablet, are indicated for radiographic examination of the gastrointestinal tract. Barium sulfate suspension, when administered orally, provides contrast to help detect and evaluate abnormalities of the esophagus, the stomach, and/or the small intestine. The oral tablet form is used to detect minimal esophageal strictures. Rectal administration of barium sulfate helps detect and evaluate abnormalities of the colon and/or distal small intestine. {02} {11} {21} {22} {39} {40} {41} {43} {44} {45} {46} {47} {48} {49} {50} {51}

Body imaging, computed tomographic—Oral or rectal barium sulfate suspension, in low concentration, is indicated for enhancement of computed tomographic images (CT of the body) to delineate the gastrointestinal tract. {13} {14} {15} {16} {17} {18} {36} {37} {38} {42} {44}


Pharmacology/Pharmacokinetics

Physicochemical characteristics:
Molecular weight—
    233.39

Mechanism of action/Effect:

Barium sulfate increases the absorption of x-rays as they pass through the body, thus delineating body structures, in which barium sulfate is localized. {02} {11} {12} {27} {46}

Absorption:

No significant absorption from gastrointestinal tract (some of the additives are absorbed). {02} {11} {27} {46} {53}


Time to peak opacification:

Esophagus, stomach, and duodenum—Almost immediate after oral administration. {53}

Small intestine (anterograde examination)—Dependent on gastric emptying rate and viscosity of the preparation; may be delayed 15 to 90 minutes.

Small intestine (enteroclysis studies)—Immediate, following direct instillation of preparation into small intestine.

Colon and distal small intestine (retrograde examination)—Patient positioning and hydrostatic pressure determines the rate and degree of opacification.

Elimination:
    Fecal. {11} {53}


Precautions to Consider

Pregnancy/Reproduction

Pregnancy—
Elective contrast radiography of the abdomen is usually not recommended during pregnancy because of the risks to the fetus from radiation exposure. {46}

Breast-feeding

Problems in humans have not been documented.

Pediatrics

Two deaths of infants from barium aspiration have been reported; however, the volume of aspirated material rather than the nature of the material was probably the responsible factor. {02}


Geriatrics


Diagnostic studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of barium sulfate in the elderly. {27} However, colon distention has caused electrocardiographic changes, especially in geriatric patients with a history of cardiac disease. {53}

Medical considerations/Contraindications
The medical considerations/contraindications included have been selected on the basis of their potential clinical significance (reasons given in parentheses where appropriate)— not necessarily inclusive (» = major clinical significance).


Except under special circumstances, this medication should not be used when the following medical problems exist:
» Colon obstruction, known or suspected    (oral administration of barium sulfate may increase risk of impaction {02} {46})


» Gastrointestinal tract perforation    (increased risk of intraperitoneal spread of barium sulfate with oral or rectal administration; prolonged exposure of peritoneum to barium sulfate may result in ascites, peritonitis, and adhesions {02} {20} {21} {22} {46})


Risk-benefit should be considered when the following medical problems exist
Allergies or asthma, history of, or
Sensitivity to barium sulfate preparations    (increased risk of anaphylactoid reaction to additives [e.g., suspending agents, flavoring agents] in the barium sulfate formulation {05} {07} {27} {46} {53})


Cystic fibrosis    (increased risk of obstruction of the small bowel {02} {23})


» Dehydration    (increased risk of impaction {02})


Diverticulitis, acute, or
Ulcerative colitis, acute    (rectal administration of barium sulfate may increase risk of perforation of the colon {11})


» Gastrointestinal tract obstruction    (condition may be aggravated {08} {11} {46})




Side/Adverse Effects

Note: Perforation of the colon after rectal administration of barium sulfate suspension has occurred rarely due to hydrostatic pressure of the instilled suspension, trauma to the colon from the enema tip, or forceful or deep insertion of a firm enema tip. Perforation of the colon has led to peritonitis, adhesions, granulomas, and death. {02} {04} {11} {53}

The following side/adverse effects have been selected on the basis of their potential clinical significance (possible signs and symptoms in parentheses where appropriate)—not necessarily inclusive:

Those indicating need for medical attention
Incidence rare
    
Anaphylactoid reaction{02}{05}{07} (wheezing, tightness in chest, or troubled breathing)
    
appendicitis{11} (stomach or lower abdominal pain, severe cramping, bloating, nausea, or vomiting)
    
fecal impaction{11}{52} (severe continuing constipation)

Note: Allergic-like reactions have been attributed to additives in the barium sulfate suspension, to other medications, such as glucagon, anticholinergic agents, or rectal lubricants, given at the time of the procedure, and, more recently, to the latex inflatable cuff on some enema tips. {02} {07} {27} {28} {29} {30} {31} {32} {46}




Those indicating need for medical attention only if they continue or are bothersome
Incidence more frequent
    
Constipation
    
intestinal cramping{11}
    
diarrhea{02}{11}

Note: Intestinal cramping and diarrhea may be the result of intestinal distention produced by large volumes of barium sulfate enema. {27} {53}






Patient Consultation
As an aid to patient consultation, refer to Advice for the Patient, Barium Sulfate (Diagnostic).

In providing consultation, consider emphasizing the following selected information (» = major clinical significance):

Description of use
Action in the body: Oral/rectal administration; visualization of radiopacity in the gastrointestinal tract possible with x-rays

» Proper dosing

Before having this test
»   Conditions affecting use, especially:
Sensitivity to barium sulfate formulations

Pregnancy—Risk to the fetus from radiation exposure
Other medical problems, especially dehydration, known or suspected obstruction of the colon, or gastrointestinal tract perforation or obstruction

Preparation for this test
Patient should inquire in advance regarding special instructions

For oral administration of barium sulfate: Not eating after 8 in the evening; not drinking liquids after midnight

For rectal administration of barium sulfate: Eating residue-free meals and using a laxative on day before examination

Precautions after having this test
Increased intake of liquids to prevent impaction after oral administration


Side/adverse effects
Signs of potential side effects, especially allergic-like reaction, appendicitis, and fecal impaction


General Dosing Information
Barium sulfate should not be administered in its dry form since accidental inhalation, esophageal irritation or blockage, or intestinal blockage may occur. The powder must be reconstituted, and some of the commercially prepared suspensions require further dilution, prior to administration. The manufacturer's literature should be consulted for specific techniques and procedures for reconstitution and administration of the different barium sulfate preparations. {02} {27}

Increased intake of liquids is recommended after oral or rectal administration of barium sulfate to prevent severe constipation and the risk of impaction. {11} {27} {52}

For oral dosage forms
On the evening before the examination, a residue-free dinner is recommended. Intake of food after 8 in the evening is not recommended; intake of clear liquids may continue up to midnight.

For rectal dosage forms
On the day prior to the examination, a residue-free diet and a laxative are usually recommended. {24}

A bisacodyl suppository may be used the morning of the examination. {27}


Oral or Rectal Dosage Forms

BARIUM SULFATE USP

Usual adult and adolescent dose
Gastrointestinal tract radiographic examination {27}


Oral:
Esophagus, single contrast—5 to 150 mL of a suspension containing 60 to 155% weight per volume (w/v) (40 to 75% weight in weight [w/w]) of barium sulfate.

Esophagus, double contrast—15 to 140 mL of a suspension containing 60 to 250% w/v (40 to 85% w/w) of barium sulfate.

Stomach and duodenum, single contrast—240 to 360 mL of a suspension containing 40 to 120% w/v (30 to 60% w/w) of barium sulfate.

Entire small intestine, single contrast—480 to 700 mL of a suspension containing 40 to 80% w/v(30 to 50% w/w) of barium sulfate.

Stomach, double contrast—Initially, 75 to 140 mL of a suspension containing 200 to 250% w/v (80 to 85% w/w) of barium sulfate for gastric coating. After gastric coating is observed and radiographs are taken, an additional 150 to 300 mL of a suspension containing 40 to 80% w/v (30 to 50% w/w) of barium sulfate is administered. {27}

Single contrast enteroclysis studies (small intestine examination via oral tube into the duodenum)—500 to 2400 mL of a suspension containing 24 to 50% w/v (20 to 35% w/w) of barium sulfate.



Rectal:
Small intestine, retrograde examination—2 to 2.5 L of a suspension containing 20% w/v (17% w/w) of barium sulfate.

Colon, single contrast—1.5 to 2.5 L of a suspension containing 17 to 40% w/v (15 to 30% w/w) of barium sulfate.

Colon, double contrast—350 to 1000 mL of a suspension containing 85 to 125% w/v (50 to 65% w/w) of barium sulfate.


CT of the body
Oral: 200 to 500 mL of a suspension containing 1 to 2% w/v(1 to 2% w/w) of barium sulfate. {36}


Usual pediatric dose
Gastrointestinal tract radiographic examination—Dosage must be individualized by physician. In general, the following concentrations of barium sulfate suspensions are used: {02}


Oral:
Upper GI, single contrast: 50 to 100% w/v (35 to 56% w/w).

Upper GI, double contrast: 200 to 250% w/v (80 to 85% w/w).

Small intestine follow-through studies: 50 to 100% w/v (35 to 56% w/w).

Enteroclysis studies: 20 to 30% w/v (17 to 20% w/w).



Rectal:
Colon, single contrast: 15 to 20% w/v (15 to 17% w/w).

Colon, double contrast: 80 to 120% w/v (50 to 60% w/w).



Usual geriatric dose
See Usual adult and adolescent dose.

Size(s) usually available:
U.S.—
{27}{33}

180 gram (Rx) [Tonopaque{35}]


1 lb (Rx)[Generic]


5 lb (Rx)[Generic]

Canada—


25 kg (Rx)[Generic]

Packaging and storage:
Store below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), unless otherwise specified by manufacturer. Store in a well-closed container.

Preparation of dosage form:
Barium sulfate powder should not be taken in its dry form. To prepare suspension, water is added to the powder. Flavoring may be added, if needed.

See manufacturer's package insert for complete instructions on reconstitution.

Note: Suspension should be shaken vigorously just before administration.



BARIUM SULFATE SUSPENSION

Usual adult and adolescent dose
See Barium Sulfate USP .

Usual pediatric dose
See Barium Sulfate USP .

Usual geriatric dose
See Barium Sulfate USP .

Strength(s) usually available
U.S.—


1.5% w/w (Rx) [Prepcat]


2.2% w/w (Rx) [mede-SCAN]


5% w/v (Rx) [Tomocat]


60% w/v (Rx) [Liquid Barosperse]


85% w/v (Rx) [HD 85{48}]


100% w/v (Rx) [Medebar Plus] [Polibar Liquid]


105% w/v (Rx) [Polibar Plus]

Canada—


1.2% w/v (Rx) [Readi-CAT]


100% w/v (Rx) [Polibar]


105% w/v (Rx) [Polibar Plus] [Polibar Rapide]

Packaging and storage:
Store below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), unless otherwise specified by manufacturer. Store in a well-closed container.

Preparation of dosage form:
To achieve other desired concentrations, manufacturer's package insert should be consulted for dilution instructions.

Note: Suspension should be shaken vigorously just before administration.




Oral Dosage Forms

BARIUM SULFATE ORAL SUSPENSION

Usual adult and adolescent dose
Gastrointestinal tract radiographic examination
Oral:

Esophagus, single contrast—5 to 150 mL of a suspension containing 60 to 155% weight per volume (w/v) (40 to 75% weight in weight [w/w]) of barium sulfate.

Esophagus, double contrast—15 to 140 mL of a suspension containing 60 to 250% w/v (40 to 85% w/w) of barium sulfate.

Stomach and duodenum, single contrast—240 to 360 mL of a suspension containing 40 to 120% w/v (30 to 60% w/w) of barium sulfate. {27}

Entire small intestine, single contrast—480 to 700 mL of a suspension containing 40 to 80% w/v (30 to 50% w/w) of barium sulfate.

Stomach, double contrast—Initially, 75 to 120 mL of a suspension containing 200 to 250% w/v (80 to 85% w/w) of barium sulfate for gastric coating. After gastric coating is observed and radiographs are taken, an additional 150 to 300 mL of a suspension containing 40 to 80% w/v (30 to 50% w/w) of barium sulfate is administered.

Single contrast enteroclysis studies (small intestine examination via oral tube into the duodenum)—500 to 2400 mL of a suspension containing 24 to 50% w/v (20 to 35% w/w) of barium sulfate. {45}

CT of the body
Oral: 200 to 500 mL of a suspension containing 1 to 2% w/v(1 to 2% w/w) of barium sulfate.


Usual pediatric dose
Gastrointestinal tract radiographic examination—Dosage must be individualized by physician. In general, the following concentrations of barium sulfate suspensions are used: Oral {02}
Upper GI, single contrast: 50 to 100% w/v (35 to 56% w/w).

Upper GI, double contrast: 200 to 250% w/v (80 to 85% w/w).

Small intestine follow-through studies: 50 to 100% w/v (35 to 56% w/w).

Enteroclysis studies: 20 to 30% w/v (17 to 20% w/w).


Usual geriatric dose
See Usual adult and adolescent dose.

Strength(s) usually available
U.S.—
{27}

1.2% w/w (Rx) [Readi-CAT]


1.5% w/w (Rx) [Baro-cat]


2.0% w/w (Rx) [Readi-CAT 2]


3.0% w/w (Rx) [Esopho-CAT Esophageal Cream]


4.9% w/v (Rx) [E-Z-CAT] [Tomocat] [Tomocat 1000]


50% w/v (Rx) [Entrobar]


60% w/v (Rx) [E-Z-Paque Liquid] [Gil-Paque]


72% w/v (Rx) [Sol-O-Pake Liquid]


80% w/v (Rx) [Entero-H]


100% w/v (Rx) [Esophotrast Esophageal Cream]


120% w/v (Rx) [E-Z-Paste Esophageal Cream]


220% w/v (Rx) [Liquid HD]

Canada—


1.2% w/v (Rx) [Readi-CAT]


3.0% w/w (Rx) [Esopho-CAT Esophageal Cream]


4.6% w/w (Rx) [E-Z-CAT]


136% w/v (Rx) [Esobar]


210% w/v (Rx) [Maxibar]


100% w/v (Rx) [Unibar-100]

Packaging and storage:
Store below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), unless otherwise specified by manufacturer. Store in a well-closed container.

Preparation of dosage form:
To achieve other desired concentrations, manufacturer's package insert should be consulted for dilution instructions.

Note: Suspension should be shaken vigorously just before administration.



BARIUM SULFATE FOR SUSPENSION (ORAL) USP

Usual adult and adolescent dose
See Barium Sulfate Oral Suspension .

Usual pediatric dose
See Barium Sulfate Oral Suspension .

Usual geriatric dose
See Barium Sulfate Oral Suspension .

Strength(s) usually available
U.S.—


28% w/w (Rx) [Liqui-Jug]


28 to 56% w/w (Rx) [Polibar Flavored]


40% w/w (Rx) [E-Z-Jug] [Sol-O-Pake] [Ultra-R]


75% w/w (Rx) [E-Z-Paque]


85% w/w (Rx) [Baricon] [E-Z-HD]


95% w/w (Rx) [Barosperse]


96% w/w (Rx) [Tonojug 2000]


98% w/w (Rx) [Baricon] [HD 200 Plus]

Canada—


40% w/w (Rx) [E-Z-Jug]


40% w/w (Rx) [Ultra-R]


85% w/w [E-Z-HD]


Variable concentration (Rx) [E-Z-Paque]

Packaging and storage:
Store below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), unless otherwise specified by manufacturer. Store in a well-closed container.

Preparation of dosage form:
Barium sulfate powder should not be taken in its dry form. To prepare suspension, water is added to the powder. Flavoring may be added, if desired.

See manufacturer's package insert for complete instructions on reconstitution.

Note: Suspension should be shaken vigorously just before administration.



BARIUM SULFATE TABLETS

Usual adult and adolescent dose
Esophageal stricture detection
Oral, 1 tablet administered with one or two swallows of water just prior to esophagoscopy. {27}


Usual pediatric dose
Dosage has not been established.

Usual geriatric dose
See Usual adult and adolescent dose .

Strength(s) usually available
U.S.—


650 mg (Rx) [E-Z-Disk]

Canada—
Not commercially available.

Packaging and storage:
Store below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), unless otherwise specified by manufacturer. Store in a well-closed container.



Rectal Dosage Forms

BARIUM SULFATE RECTAL SUSPENSION

Usual adult and adolescent dose
Gastrointestinal tract radiographic examination
Rectal:

Small intestine, retrograde examination—2 to 2.5 L of a suspension containing 20% w/v (17% w/w) of barium sulfate.

Colon, single contrast—1.5 to 2.5 L of a suspension containing 17 to 40% w/v (15 to 30% w/w) of barium sulfate.

Colon, double contrast—350 to 1000 mL of a suspension containing 85 to 125% w/v (50 to 65% w/w) of barium sulfate. {46}


Usual pediatric dose
Gastrointestinal tract radiographic examination—Dosage must be individualized by physician. In general, the following concentrations of barium sulfate suspensions are used: {02}
Rectal:

Colon, single contrast: 15 to 20% w/v (15 to 17% w/w).

Colon, double contrast: 80 to 120% w/v (50 to 60% w/w). {46}


Usual geriatric dose
See Usual adult and adolescent dose .

Strength(s) usually available
U.S.—


1.2% w/w (Rx) [Readi-CAT Unflavored]


5% w/v (Rx) [Enecat]


43% w/w (Rx) [EvacuPaste]


85% w/v (Rx) [Probar]


100% w/v (Rx) [Anatrast] [E-Z-AC] [Flo-Coat] [Liquipake] [Polibar Liquid]


105% w/v (Rx) [E-Z-Dose] [Polibar Plus]


150% w/v (Rx) [Epi-C{46}]

Canada—


43% w/w (Rx) [EvacuPaste]


100% w/v (Rx) [Polibar Liquid]


105% w/v (Rx) [Polibar Plus]

Packaging and storage:
Store below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), unless otherwise specified by manufacturer. Store in a well-closed container.

Preparation of dosage form:
To achieve other desired concentrations, manufacturer's package insert should be consulted for dilution instructions.

Note: Suspension should be shaken vigorously just before administration.



BARIUM SULFATE FOR SUSPENSION (RECTAL) USP

Usual adult and adolescent dose
See Barium Sulfate Rectal Suspension .

Usual pediatric dose
See Barium Sulfate Rectal Suspension .

Usual geriatric dose
See Barium Sulfate Rectal Suspension .

Strength(s) usually available
U.S.—
{27}{33}

94% w/w (Rx) [Polibar]


95% w/w (Rx) [Exacta I] [Exacta II]


95% w/w (Rx) [Barosperse] [E-Z-Paque Enema]


96% w/w (Rx) [Medebag{50}]


96.7% w/w (Rx) [ACB]


97% w/w (Rx) [Barobag] [Sol-O-Pake]

Canada—


Variable strength (Rx) [ACB] [E-Z-Paque]


Variable strength (Rx) [Recto-Barium]

Packaging and storage:
Store below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), unless otherwise specified by manufacturer. Store in a well-closed container.

Preparation of dosage form:
Barium sulfate powder should not be used in its dry form. To prepare suspension, water is added to the powder.

See manufacturer's package insert for complete instructions on reconstitution.

Note: Suspension should be shaken vigorously just before administration.




Revised: 07/26/1994



References
  1. Package inserts/product carton.
  1. Cohen MD. Choosing contrast media for pediatric gastrointestinal examinations. Crit Rev Diagn Imaging 1990; 30(4): 3174-80.
  1. Buschman DL. Barium sulfate bronchography. Report of a complication. Chest 1991; 99: 747-9.
  1. Mary Lindquist v. York X-ray & Osteoporosis Center, Inc., and Sai B. Yoon, M.D., Cuyahoga County (OH) Court of Common Pleas, Case No. 178998. Rupture of colon during barium enema. Med Malpractice Verdicts Settlements & Experts 1991; 7: 62.
  1. Feczko PJ, et al. Fatal hypersensitivity reaction during barium enema. Am J Radiol 1989; 153: 275-6.
  1. Lipson A, Bartram CI, Williams CB, et al. Barium studies and ileoscopy compared in children with suspected Crohn's disease. Clin Radiol 1990; 41(1): 5-8.
  1. Al-Mudall R, et al. Anaphylactic reaction to barium enema. Am J Med 1990; 89: 251.
  1. Saunders MP. Large bowel obstruction due to an impacted barolith. A delayed complication of a barium study. Postgrad Med J 1990; 66: 684-5.
  1. Nightingale SL. Severe adverse reactions to barium enema procedures. JAMA 1990; 264(22): 2863.
  1. Dantas RO, Dodds WJ, Massey BT, et al. The effect of high- vs low-density barium preparation on the quantitative features of swallowing. Am J Roentgenol 1989; 153(6): 1191-5.
  1. Reynolds JEF, editor. Martindale, the extra pharmacopeia. 29th ed. London: The Pharmaceutical Press, 1989: 862-3.
  1. Pottorf v. Favelukes, M.D., Maricopa County (AZ) Superior Court, Case No. 88-19859. Plaintiff alleged failure to discontinue barium enema procedure upon complaints of pain—Ruptured cecum. Med Malpractice 1990; 6: 61.
  1. Hatfield KD, Segal SD, Tait K. Barium sulfate for abdominal computer assisted tomography. J Comput Assist Tomogr 1980; 4(4): 570.
  1. Megibow AJ, Bosniak MA. Dilute barium as a contrast agent for abdominal CT. AJR 1980; 134(6): 1273-4.
  1. Chen YM, Ott DJ, Wolfman NT, et al. Recurrent colorectal carcinoma evaluation with barium enema examination and CT. Radiology 1987; 163(2): 307-10.
  1. Johnson CD. Diagnosis of acute colonic diverticulitis: comparison of barium enema and CT. Am J Roentgenol 1987; 148(3): 541-6.
  1. Safrit HD, Rice RP, Dunnick NR. Recurrent colorectal carcinoma: evaluation with barium enema examination and CT. Invest Radiol 1988; 23(3): 233-4.
  1. Gardner DJ, Hanson RE. Computed tomography of retroperitoneal perforation after barium enema. Clin Imaging 1990; 14(3): 208-10.
  1. Gurwitz JH, Noonan JP, Sanchez M, et al. Barium enemas in the frail elderly. Am J Med 1992; 92(1): 41-4.
  1. Ginai AZ, ten Kate FJ, ten Berg R, et al. Experimental evaluation of various available contrast agents for use in the upper gastrointestinal tract in case of suspected leakage: effects on mediastinum. Br J Radiol 1985; 58(691): 585-92.
  1. Foley MJ, Ghahremani GG, Rogers LF. Reappraisal of contrast media used to detect upper gastrointestinal perforations. Radiology 1982; 144: 231-7.
  1. Dodds WJ, Stewart ET, Vlymen WJ. Appropriate contrast media for evaluation of esophageal disruption. Radiology 1982; 144: 439-41.
  1. Fischer WW, Nice CM, Jr. Barium impaction as a cause of small bowel obstruction in an infant with cystic fibrosis. Pediatr Radiol 1984; 14: 230.
  1. Bisacodyl tannex package insert (Clysodrast, Armour—US), Rev 6/89.
  1. Ros PR, Steinman RM, Torres GM, et al. The value of barium as a gastrointestinal contrast agent in MR imaging: a comparison study in normal volunteers. Am J Roentgenol 1991; 157(4): 761-7.
  1. Panaccione JL, Ros PR, Torres GM, et al. Rectal barium in pelvic MR imaging: initial results. J Magn Reson Imaging 1991; 1(5): 605-7.
  1. Reviewers' responses to monograph revision of 02/01/92.
  1. Gelfand DW, Sowers JC, DePonte KA, et al. Anaphylactic and allergic reactions during double-contrast studies: is glucagon or barium suspension the allergen? Am J Roentgenol 1985; 144(2): 405-6.
  1. Gelfand DW. Barium enemas, latex balloons, and anphylactic reactions. Am J Roentgenol 1991; 156(1): 1-2.
  1. Lavaud F. Latex allergy in patient with allergy to fruit [letter]. Lancet 1992; 339: 492-3.
  1. Ownby DR, Tomlanovich M, Sammons N, et al. Anaphylaxis associated with latex allergy during barium enema examinations. Am J Roentgenol 1991; 156(5): 903-8.
  1. Slater JE. Rubber anaphylaxis. N Engl J Med 1989; 320(17): 1126-9.
  1. E-Z-EM GI Radiology Products Catalog, 1990 (Rec 4/92).
  1. Reviewers' responses to monograph revision of 04/22/92.
  1. Tonopaque package insert (Lafayette—US), Rev 1/92, Rec 7/93.
  1. Prepcat package insert (Lafayette—US), Rev 11/91, Rec 7/93.
  1. Tomocat package insert (Lafayette—US), Rev 1/92, Rec 7/93.
  1. mede-SCAN package insert (Lafayette—US), Rev 6/92, Rec 7/93.
  1. Anatrast package insert (Lafayette—US), Rev 1/92, Rec 7/93.
  1. Baricon package insert (Lafayette—US), Rev 1/92, Rec 7/93.
  1. Barobag package insert (Lafayette—US), Rev 12/91, Rec 7/93.
  1. Baro-cat package insert (Lafayette—US), Rev 11/91, Rec 7/93.
  1. Barosperse package insert (Lafayette—US), Rev 11/91, Rec 7/93.
  1. Enecat package insert (Lafayette—US), Rev 12/91, Rec 7/93.
  1. Entrobar package insert (Lafayette—US), Rev 11/91, Rec 7/93.
  1. Epi-C package insert (Lafayette—US), Rev 12/91, Rec 7/93.
  1. Flo-Coat package insert (Lafayette—US), Rev 2/92, Rec 7/93.
  1. HD 85 package insert (Lafayette—US), Rev 11/91, Rec 7/93.
  1. HD 200 Plus package insert (Lafayette—US), Rev 11/91, Rec 7/93.
  1. Medebag package insert (Lafayette—US), Rev 1/92, Rec 7/93.
  1. Medebar Plus package insert (Lafayette—US), Rev 10/92, Rec 7/93.
  1. Halliday KE, Patel SR, Baker WNW. Case report: colonic obstruction following small bowel barium study. Br J Radiol 66: 725-6.
  1. Swanson DP, Chilton HM, Threll JH, editors. Pharmaceuticals in Medical Imaging. New York: MacMillan Publishing Company, 1990: 155-63.
Hide
(web2)