Text:
A previously healthy 42-year-old male was admitted to our hospital with
a complaint of abdominal pain for a day. The patient’s vital signs were
within normal range, and he had no physical findings other than
tenderness in the upper right abdomen. Blood analysis showed elevations
of C-reactive protein (5.4 mg/dL). Computed tomography revealed high
density in the appendix (Fig A ), and the patient was diagnosed
with appendicitis. Subsequent interviews revealed that the patient was
taking barium for a medical examination three days before his visit. The
patient underwent antibiotic treatment for barium appendicitis.
Barium remains in the appendix for more than 72 hours in only 8% of
patients (1), and in a small number of these patients, the remaining
barium obstructs the lumen of the appendix and causes appendicitis (2).
Since barium is widely used in gastric cancer screening in Japan, the
diagnosis and recognition of barium appendicitis is particularly
valuable.