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Small bowel injury after suprapubic catheter insertion presenting 3 years after initial insertion
Kevin M Gallagher1, Daniel W Good, John P Brush
1Department of Urology, Western General Hospital Edinburgh, Edinburgh, Mid Lothian, UK.
BMJ Case Reports
|December 12, 2013
Summary
Bowel perforation is a rare complication of suprapubic catheter (SPC) placement. This case highlights that SPC blockage years later may indicate a fistula, even without abdominal pain.
Area of Science:
- Urology
- Gastroenterology
- Surgical Complications
Background:
- Suprapubic catheter (SPC) placement is a common urological procedure.
- Complications, though rare, can occur years after initial insertion.
Observation:
- A 77-year-old woman presented with a blocked SPC, draining cloudy green fluid.
- Cystoscopy revealed bilious material and a fistulous tract entering the bladder.
- CT scan confirmed the SPC tract transfixed a loop of small bowel.
Findings:
- The patient had a small bowel perforation into the bladder, forming a fistula.
- No intraperitoneal contrast leak was detected.
- The patient recovered without requiring laparotomy.
Implications:
- Bowel perforation should be considered in patients with late-onset SPC issues, even without typical peritonitis symptoms.
- This case underscores the importance of considering gastrointestinal complications following suprapubic catheterization.
- Diagnostic imaging is crucial for identifying unusual fistulous tracts.
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