Fatal hypersensitivity reaction during a barium enema.

Barium contrast examinations of the gastrointestinal tract are considered relatively innocuous procedures; most major complications result from perforation of the bowel. Allergic reactions to the contrast material have long been considered extremely rare, although there have been increasing reports of allergic complications due to the contrast material or glucagon [1 , 2]. Most reports have described fairly mild allergic reactions with pruritus, urticaria, and some edema [1 , 2]. Occasionally, the reactions have been more serious, and respiratory distress has occurred [3]. At least one well-substantiated death, which appeared to be due to an anaphylactoid response, has occurred during a barium enema [4]. We report a case of a woman with an extensive history of allergy who had a fatal anaphylactoid reaction during a single-contrast barium enema.