Presentation
Palliative patient. Assessment for pelvic collection.
Patient Data
Air within the subcutaneous soft tissues is seen of the right inguino-scrotal region extending upward along the anterior abdominal wall on the right indicating necrotizing fasciitis.
Mal-placement of the Foley balloon of the urinary catheter which is extra-vesicle, located in the recto-vesical pouch. Small hematoma is evident adjacent to it.
Distended urinary bladder with fullness of both pelvicalyceal systems.
Trace right subphrenic ascites and small right pleural effusion.
Vertebral body fractures.
Case Discussion
Incidental finding of a mal-placed urinary catheter. Following CT findings the clinical notes indicated difficult catheterization and the use or a wire to secure 'insertion'.
Flexible cystoscopy was performed. The urinary catheter was along a false passage undermining the bladder neck with the balloon in the recto-vesical pouch.