Bowel perforation presenting three months after suprapubic catheter insertion

BMJ Case Rep. 2017 Sep 7:2017:bcr2017220791. doi: 10.1136/bcr-2017-220791.

Abstract

An 82-year-old male with multiple comorbidities, including previous laparotomies, had a suprapubic catheter (SPC) inserted under guidance with ultrasound and a flexible cystoscope. Three months following the procedure, having returned for a flexible cystoscopy for ongoing bladder pain syndrome, he became peritonitic postoperatively.A CT scan and subsequent laparotomy confirmed the SPC to be passing through a section of terminal ileum. The bowel was resected and he recovered well after a long hospital admission. A literature search found this delayed presentation of bowel perforation following SPC insertion to be rare, with only a few other cases reported. In particular, previous abdominal surgery increases the risk of this complication. This case serves as a reminder of the rare but potentially significant risk of SPC insertion and unusually highlights that this may not present immediately.

Keywords: catheterisation / catheter care; general surgery; urological surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Cystoscopy / adverse effects
  • Cystostomy / adverse effects*
  • Cystostomy / instrumentation
  • Humans
  • Ileum / diagnostic imaging
  • Ileum / injuries*
  • Ileum / pathology
  • Intestinal Perforation / complications
  • Intestinal Perforation / etiology*
  • Laparotomy / methods
  • Male
  • Peritonitis / complications
  • Postoperative Complications / pathology
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Interventional / methods