A potential hazard of barium cystography.
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CYSTOURETHROGRAPHY with visualization of the urethra during micturition is frequently hampered by the irritative effect of the contrast medium upon the urethra. Small children, particularly, often refuse to void. Bartley and Helander (l) believe Dionosil" is less irritating than Urokon.3 Doyle (2) and Hallgren et al. (3) have employed barium sulfate without complication. Their results prompted us to explore the use of barium sulfate as a contrast agent in children in an effort to secure more normal urethrograms. We wish to report a disturbing complication following reflux into the renal cortex and the subsequent appearance of barium casts in the urine. Methods In Children: Micropaque barium (<50 μ, particles) was utilized after its introduction into the obstructed renal pelvis of a pig failed to result in stone formation. The Micropaque was injected into the bladder as a sterile solution of 150 ml of medium in one liter of physiological saline. One hundred children with urinary tract symptoms were studied...