Spontaneous knotting of a feeding tube in the bladder

Urinary catheterization is often performed in the pediatric age group. The procedure although safe, is not free of complications. Knotting of the urinary catheter is a rare but serious complication. A seven-year-old boy presented with left-sided neuroblastoma and underwent an exploratory laparotomy during which it was found that he had an inoperable tumor. There was a nodule obstructing the left ureter. This was resected and an end-to-end anastomosis of the ureter was carried out. A size 8 French (Fr) feeding tube was introduced through the urethra to monitor the patient's urine output and fluid balance in the absence of a self-retaining pediatric catheter. An attempt at removal 48 h later was unsuccessful. The patient was afterwards, on the sixth postoperative day, anaesthetized and the tube was pulled out. It was noticed that the catheter was knotted. The case is reported with a limited discussion of relevant literature. Spontaneous knotting of a catheter is a rare complication. With availability of appropriate catheters and adequate knowledge and skill, this complication can be reduced to the barest minimum.