Barium intravasation

Last revised by Andrew Murphy on 23 Mar 2023

Barium intravasation represents the feared - and fortunately very rare - complication of passage of barium sulfate contrast medium from the GI tract into the bloodstream.

Entry of barium into the bloodstream, usually the venous circulation is very rare, and a paper published in 2005 stated that there were 36 reported cases in the literature in the previous 50 years 3. Of these cases, ~48% were fatal.

Clinical features invariably varies with the specific vessels into which the barium intravasates. Common features include:

Unfortunately, serious sequelae are not uncommon:

Often the first sign is barium visualization in the vessels during the procedure.

Clearly experience with what is the most successful treatment strategy is very limited in view of the rarity of this complication.

  • immediately cease the procedure as soon as intravasation is suspected
  • head up positioning of patient to reduce chance of barium entering the pulmonary circulation
  • intensive monitoring +/- fluid resuscitation

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Cases and figures

  • Case 1: barium intravasation into the portal vein
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