Iatrogenic perforation of the colon and rectum

Abstract
In 8 yr at Cook County Hospital, Illinois, USA, 42,000 Ba enemas, 16,325 proctosigmoidoscopies and 1207 colonscopies were performed. All endoscopic procedures were done by the house staff. There were 3 perforations due to proctosigmoidoscopy, with 1 death; 3 perforations due to colonoscopy, with no deaths and 7 perforations due to Ba enema, with no survivors. The adjuvant effect of Ba sulfate is proposed as the most likely cause for this excessively high mortality in Ba-enema perforation.