Abstract
BackgroundSuprapubic catheterization is a common procedure employed by urologists to manage long standing voiding dysfunction or neuropathic bladders in patients. Bowel injury is a rare but important complication, in light of the consequences to patient morbidity.Case presentationAn 81 year old Caucasian female presented with a blocked suprapubic catheter 3 weeks after passage under cystoscopic guidance. The Foley catheter was replaced and attempted aspiration brought up a faeculent fluid. There were no signs to suggest peritonitis. Catheter was kept in situ until computed tomography imaging was obtained; this illustrated the catheter in small bowel with balloon inflated, causing partial small bowel obstruction. Patient underwent exploratory laparotomy with bowel resection, with an uneventful post-operative recovery.ConclusionWe speculate that the injury occurred at the time of first catheter exchange, with the tip directly piercing the small bowel. To our knowledge this particular mechanism of injury has not previously been reported. This case demonstrates the importance of remaining vigilant to iatrogenic bowel injury after cystostomy, and aids initial management if injury is suspected.
Highlights
Suprapubic catheterization is a common procedure employed by urologists to manage long standing voiding dysfunction or neuropathic bladders in patients
We speculate that the injury occurred at the time of first catheter exchange, with the tip directly piercing the small bowel. To our knowledge this particular mechanism of injury has not previously been reported. This case demonstrates the importance of remaining vigilant to iatrogenic bowel injury after cystostomy, and aids initial management if injury is suspected
Suprapubic catheterization is an increasingly common procedure undertaken by Urologists
Summary
We present an unusual complication of suprapubic catheter replacement; the formation of an iatrogenic enterocutaneous fistula. It would be prudent of surgeons to remain vigilant of such complications, particular in the aging population. This case highlights that in the event of potential bowel injury, catheter should remain undisturbed until cross sectional imaging has been acquired. Publish with Bio Med Central and every scientist can read your work free of charge "BioMed Central will be the most significant development for disseminating the results of biomedical researc h in our lifetime.". Your research papers will be: available free of charge to the entire biomedical community peer reviewed and published immediately upon acceptance cited in PubMed and archived on PubMed Central yours — you keep the copyright.
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