Beyond the bowel: Computed tomography (CT) Scan identification of intraperitoneal bladder perforation causing mechanical small bowel obstruction

Intraperitoneal bladder perforation can rarely cause mechanical small-bowel obstruction. A man with benign prostatic hyperplasia and longstanding transurethral catheterisation presented with abdominal pain, distension, obstipation and vomiting. Computed tomography demonstrated small-bowel obstruction with an ileal transition point adjacent to the catheter tip traversing the bladder dome. Surgical exploration revealed an ileal loop adherent to the perforated bladder. Adhesiolysis relieved the obstruction, and the bladder defect was debrided and repaired in two layers. This case highlights the importance of assessing catheter position and bladder integrity on computed tomography in chronically catheterised patients presenting with bowel obstruction, enabling recognition and multidisciplinary management.