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Small-bowel obstruction caused by a long-term indwelling urinary catheter
L P Sullivan1, P G Davidson, D A Kloss
1Staten Island Hospital, N.Y.
Surgery
|February 1, 1990
Summary
A long-term Foley catheter caused a rare small-bowel obstruction by migrating through a vesicoenteric fistula. Computed tomography scans were crucial for diagnosing this unusual complication of urinary catheter use.
Area of Science:
- Gastroenterology
- Urology
Background:
- Urinary catheters, particularly long-term indwelling Foley catheters, are common medical devices.
- Complications associated with urinary catheters are infrequent, with recurrent urinary-tract infections being the most common.
Observation:
- This case report details the first known instance of a small-bowel obstruction directly caused by a long-term indwelling Foley catheter.
- The obstruction occurred when the catheter's balloon migrated into the distal ileum.
- This migration was facilitated by a vesicoenteric fistula, a tract connecting the bladder and intestine, likely formed due to chronic irritation.
Findings:
- The primary finding is the development of a small-bowel obstruction secondary to Foley catheter balloon migration through a vesicoenteric fistula.
- The diagnostic process presented a challenge, highlighting the rarity of this specific complication.
- Preoperative computed tomographic (CT) scanning proved instrumental in accurately identifying the cause of the obstruction.
Implications:
- This case underscores the importance of considering rare but serious complications associated with long-term urinary catheter use.
- It emphasizes the diagnostic utility of advanced imaging, such as CT scans, in complex gastrointestinal presentations.
- Awareness of such potential fistulization and obstruction can guide clinical suspicion and management in patients with indwelling catheters.