Sixty cases of extraperitoneal intramural and perirectal extravasation of barium during a barium enema examination are reviewed. Approximately half the patients were asymptomatic and of these only one experienced serious complications. In the remaining patients, symptoms included pain, bleeding, fever, sepsis, mass and/or discharge. Morbidity and mortality was considerable despite aggressive treatment in many cases. Delay of treatment resulted in increase mortality and morbidity.