MCTO is a rare autosomal-dominant inherited disorder that causes bone destruction and deformity of the appendicular bones in children, with the carpal and tarsal bones severely affected. Imaging can narrow the differential diagnosis between MTCO and other diseases that cause osteolysis of the joints in children. The MCTO diagnosis is confirmed by a mutation of the MAFB gene. Teaching Point: Multicentric carpo-tarsal osteolysis (MTCO) in childhood must be considered in the differential diagnosis of severe osteolysis on radiographs.
Bladder rupture related to Foley catheter insertion is a rare condition mainly reported in patients with chronic bladder disease. In the present case, this rare condition was associated with massive hematoma due to active arterial bleeding, which was treated by embolization. We present the case of a 38-year-old woman admitted to the gastroenterology department with decompensated alcoholic liver cirrhosis, anemia, malnutrition, and diabetes. Six days after admission, she presented with hypotension and tachycardia associated with gross hematuria. An abdominal computed tomography scan revealed a Foley catheterization-related bladder perforation and a massive extra-peritoneal hematoma caused by active arterial bleeding from a distal branch of the right vesical artery. A successful embolization was performed with microparticles and coiled with complete hemorrhage control on post-procedure imaging. The bladder perforation was treated conservatively with a urinary drainage catheter, irrigation, and antibiotics. Despite these measures, the patient died 15 days later due to liver failure and sepsis. Our case highlights that commonly performed simple procedures can lead to severe complications, especially in frail patients.
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