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. 2025 Aug 6;6(1):e70182.
doi: 10.1002/deo2.70182. eCollection 2026 Apr.

Endoscopic Removal of Impacted Barium Stools Using a Snare and a Long Hood: A Rare Complication Following Upper Gastrointestinal Barium X-ray Radiography (With Video)

Affiliations

Endoscopic Removal of Impacted Barium Stools Using a Snare and a Long Hood: A Rare Complication Following Upper Gastrointestinal Barium X-ray Radiography (With Video)

Takaaki Kishino et al. DEN Open. .

Abstract

Barium sulfate is widely used as a radiographic contrast medium in upper gastrointestinal barium X-ray radiography for cancer screening in Japan. Although generally considered safe, rare complications such as bowel obstruction due to impacted barium stools can occur. We report the case of a healthy 41-year-old woman who developed colonic obstruction following upper gastrointestinal barium X-ray radiography. Endoscopic treatment was attempted using a snare and a long hood to fragment and remove the barium mass. The impacted stools were successfully removed endoscopically, and there were no serious complications such as bowel perforation or generalized peritonitis that would require surgery. This case demonstrates that endoscopic removal can be an effective and less invasive treatment option for barium impaction, which carries a risk of requiring surgical intervention. Although patients are usually advised to hydrate and take laxatives after the examination, this case highlights the importance of ensuring that patients fully understand the potential risk and the need to seek prompt medical attention.

Keywords: barium sulfate; complication; endoscopic surgical procedure; fecal impaction; upper gastrointestinal series.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Abdominal X‐ray and contrast‐enhanced computed tomography revealed a large amount of retained barium in the sigmoid colon without evidence of free air. (a) Abdominal X‐ray, (b) Abdominal computed tomography.
FIGURE 2
FIGURE 2
(a) A long hood (distal attachment, MAJ‐663; Olympus). (b) A water‐jet scope (PCF‐Q260AZI; Olympus) with the long hood. (c) A snare with a loop diameter of 25 mm (Snare Master [SD‐210U‐25]; Olympus).
FIGURE 3
FIGURE 3
Abdominal X‐ray after treatment.

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