A Rare Cause of Death in a Woman: Iatrogenic Bladder Rupture in a Patient With an Indwelling Foley Catheter

Abstract

The CDC estimates that 12–25% of all hospitalized patients receive a urinary catheter during their hospital stay. Foley catheter failure is uncommon and Foley catheter failure associated with iatrogenic urinary bladder rupture (IUBR) is extremely rare. Symptoms are often nonspecific and thus misdiagnosis and delayed treatment is common. In this case report, we present a case of IUBR in a woman from Foley catheter failure, which ultimately led to her demise. This case adds to the literature the importance of suspicion for IUBR in patients with indwelling Foley catheters presenting with lower abdominal pain, hematuria, and decreased urine output.

Pneumoperitoneum and peritonitis secondary to perforation of an infected bladder

“…Diagnosis of bladder perforation is rarely done preoperatively [ 1 , 4 , 6 ], often delayed [ 7 , 14 ] or discovered only during laparotomy [ 1 , 6 ]. Abdominal pain or peritonitis is the usual presentation.…”

“…Forty percent of bladder ruptures are intraperitoneal [ 3 ]. In the majority of cases, the presumed, but mistaken, diagnosis is digestive tract perforation [ 2 , 6 , 10 , 14 ], particularly in the presence of pneumoperitoneum [ 2 , 6 , 10 ]. Computed tomography usually shows free fluid [ 4 , 7 , 14 ], but pneumoperitoneum is demonstrated in 16% of the cases [ 9 ].…”

“…In the majority of cases, the presumed, but mistaken, diagnosis is digestive tract perforation [ 2 , 6 , 10 , 14 ], particularly in the presence of pneumoperitoneum [ 2 , 6 , 10 ]. Computed tomography usually shows free fluid [ 4 , 7 , 14 ], but pneumoperitoneum is demonstrated in 16% of the cases [ 9 ]. When diagnosis of bladder perforation is suspected, as in patients with previous bladder surgery [ 7 ], CT cystogram is the most useful diagnostic modality [ 2 , 5 , 7 , 14 ].…”

“…Computed tomography usually shows free fluid [ 4 , 7 , 14 ], but pneumoperitoneum is demonstrated in 16% of the cases [ 9 ]. When diagnosis of bladder perforation is suspected, as in patients with previous bladder surgery [ 7 ], CT cystogram is the most useful diagnostic modality [ 2 , 5 , 7 , 14 ].…”

Bladder perforation: A rare complication of retention management

“…Up to 25% of patients admitted to hospital are catheterised at least once during the course of their stay. 1 As an extremely common procedure, potential complications should be considered if the clinical course is poor.…”