Can one get injured during a barium enema test?

Yes, rarely: Rare cases of rectal perforation with the enema tip are known to occur. If there is a weakness of the colon wall from a prior surgical repair there may be leakage of the barium outside of the colon. If we know of such risks we will often start the procedure with water soluble contrast which is less trublesome for leakage but less adequate for imaging.