Presentation
Post-op laparoscopic cholecystectomy and CBD stone extraction. Delirious and self removed NGT and IDC overnight. Reviewed the following morning.
Patient Data
Retained IDC visualized in the bladder.
Mild-moderate fecal loading with gaseous distension of large bowel.
Case Discussion
In a state of delirium, the patient pulled out his indwelling urinary catheter whilst the balloon was still inflated. The nursing staff noticed that the catheter was incomplete with a missing tip. An abdominal x-ray was performed to exclude a retained foreign body. Flexible cystoscopy was performed to retrieve the catheter remnant.
This has been noted in the literature with traumatic unintended catheterizations being associated with urological complications such as increased catheter-associated urinary tract infections (UTIs), as well as increased hospital length of stay and decreased patient satisfaction scores 1.
If a Foley's catheter has been traumatically removed, then the tip must be assessed for whether the balloon is present and intact. Catheter fragments that are left in the bladder can calcify and form stones 1.