Intramural extravasation of barium simulating carcinoma of the rectum

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Abstract
Two patients with Ba granuloma of the rectum are described. The lesions appeared as indurated, ulcerated rectal masses that resembled carcinoma on endoscopic examination. Deep mucosal biopsy results demonstrated no malignancy and BaSO4 crystals in tissue macrophages. Radiographs showed persistent soft-tissue Ba in the rectum. Past reports of Ba granuloma have described ulcerated or polypoid masses in the rectum and anus. Rectal intramural extravasation of Ba occurs as a result of asymmetric enema balloon inflation and impaction of the enema tip against the rectal mucosa.

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