Iatrogenic perforation of the bladder wall following urinary catheter placement

Case contributed by Dr Ammar Haouimi

Presentation

Suprapubic pain with tenderness 12 hours following insertion of a urinary catheter in a patient with a known benign prostatic hypertrophy.

Patient Data

Age: 70 years

The ultrasound demonstrates:

The CT scan demonstrates a definite perforation of the urinary bladder. The Foley catheter tip is located above the bladder dome with a small extraperitoneal fluid collection (urinoma) is noted on the left side of the Foley catheter tip. There is also perforation of the adjacent peritoneal reflections well-visualized on sagittal reconstruction with mild free intraperitoneal fluid and fat stranding which may indicate peritonitis.

Prostatic hypertrophy as seen on ultrasound.

Other incidental findings:

  • sliding hiatal hernia
  • numerous small simple hepatic cysts
  • numerous small colonic diverticula
  • small left inguinal hernia

Case Discussion

Ultrasound and CT features of perforation of the urinary bladder following the placement of a Foley catheter with urinoma and signs of peritonitis.

Urinary bladder perforation is considered as a rare injury 1. The peritoneal dome of the urinary bladder is the weakest zone which is vulnerable to injury 2.

 

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Case information

rID: 83066
Published: 15th Oct 2020
Last edited: 15th Oct 2020
System: Urogenital
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria