Surgical Management of Intestinal Obstruction Secondary to Barium Impaction: Two Exemplary Cases.

A "barium chemobezoar" or "barolith" is a rare but serious cause of intestinal obstruction. We present two cases, a 70-year-old female patient and a 61-year-old male patient, both requiring urgent surgery for barolith-induced bowel obstruction. Diagnostic challenges were encountered in both cases, with imaging raising suspicion for barolith formation after prior barium use. Surgical intervention, including colotomy and enterotomy, was necessary due to the risk of perforation and ischemia. These cases highlight the variability in presentation and the lack of standardized guidelines for diagnosis and management, emphasizing the need for heightened clinical awareness and timely imaging.