RESUMEN
RATIONALE: Barium peritonitis is an inflammatory response that occurs when barium accidentally enters the abdominal cavity during a barium test. In extreme circumstances, it has the potential to harm various organs and even result in death. PATIENT CONCERNS: A 3-month-old infant was diagnosed with multiple organ failure after severe barium peritonitis. DIAGNOSIS: Multiple organ dysfunction is associated with barium peritonitis. INTERVENTIONS: The infant underwent surgical intervention and received ventilator support, anti-infection therapy, myocardial nutrition, liver and kidney protection, rehydration, circulation stabilization, and other symptomatic supportive care. OUTCOMES: The patient experienced clinical death after treatment and resuscitation was unsuccessful. LESSONS: Barium enema perforation complications are uncommon, but can lead to fatal injuries with a high mortality rate. This case highlights the importance of raising awareness among clinicians about the risks of gastroenterography in infants and children and actively preventing and avoiding similar serious complications. The mortality rate can be reduced by timely multidisciplinary consultation and joint management once a perforation occurs.