Cardiac Arrest During Colocutaneous Fistulography Using Barium Sulfate.
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概要
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A 68-year-old woman with an infected cutaneous fistula went into cardiac arrest during fistulography. This event occurred shortly after an inadvertent injection of barium sulfate into the cutaneous fistula subsequent to barium enema examination. X-ray films of fistulography revealed the entrance of the contrast agent into the inferior vena cava. Although the exact mechanism of intravasation remains unclear, the pressure in the fistula may have increased remarkably upon the injection of barium sulfate, resulting in the contents entering into venous drainage. Disseminated intravascular coagulation associated with apparent bleeding tendency occurred after the episode. However, pulmonary oxygenation was not greatly deteriorated and a perfusion lung scan failed to reveal pulmonary embolism that might have contributed to cardiac arrest. Another possible explanation for the abrupt collapse is the simultaneous intravasation of endotoxin or other toxic substances from the infected fistula or in the barium suspension. Therefore, we should be aware of the development of this complication at fluoroscopy, especially on the injection of contrast agent into a fistula that might have been infected with bacteria.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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