Tannic acid may be added to a barium enema solution to enhance the definition of the bowel wall. If the tannic is absorbed then hepatic toxicity can occur.
Risk factors for systemic absorption of tannic acid with the potential for hepatic toxicity:
(1) high concentration of tannic acid (<= 0.25% is relatively safe)
(2) pediatric patient
(3) multiple barium enemas given in a short period
(4) presence of inflammatory bowel disease or mucosal ulcerations
(5) prolonged retention of the enema fluid
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