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Displacement of the Urinary Catheter Mimicking Bladder Rupture
J Acute Care Surg 2019;9:27−28
Published online April 30, 2019;  https://doi.org/10.17479/jacs.2019.9.1.27
© 2019 Korean Society of Acute Care Surgery.

Dong Hun Kim, Jeongseok Yun

Department of Surgery, Trauma Center, Dankook University Hospital, Cheonan, Korea
Dong Hun Kim, M.D.
Department of Surgery, Trauma Center, Dankook University Hospital, 201 Manghyang-ro, Dongnam-gu, Cheonan 31116, Korea
Tel: +82-41-550-7661
Fax: +82-41-550-0039
E-mail: saint7331@gmail.com
ORCID: https://orcid.org/0000-0001-6613-6902
Received April 19, 2018; Revised July 23, 2018; Accepted July 24, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Body

A 46-year-old woman had multiple pelvic fractures after blunt trauma. Physical examination revealed no peritoneal irritation sign except for suprapubic tenderness with gross hematuria. Computed tomography (CT) revealed that a Foley catheter seemed like migrating into an intraperitoneal space without intraperitoneal fluid collection (Fig. 1). And then, retrograde cystography followed for the definite diagnosis of bladder injury and demonstrated normal integrity of the bladder (Fig. 2). It seems like that the displaced Foley catheter within the collapsed bladder have confused as positioning out of bladder. Patients with disruption of the pubic symphysis, pubic rami, or an unstable pelvic fracture have a high incidence of concomitant bladder trauma [1]. CT in diagnosing traumatic bladder rupture is low accuracy compared with retrograde cystography [2]. A correct procedure, such as gently pulling a urinary catheter until inflation balloon is snug against the bladder neck, might prevent the unnecessary study like this case.

Fig. 1.

Abdominal computed tomography shows a Foley catheter tip (white arrows) seen as migrating into an intraperitoneal space from bladder adjacent to the fracture of the right superior ramus with extraperitoneal hematoma. (A) Axial view and (B) Coronal view.


Fig. 2.

A retrograde cystography shows normal distension of the urinary bladder filled with contrast and the balloon of the urinary catheter placed in bladder.


Conflicts of Interest

No potential conflict of interest relevant to this article was reported.

References
  1. Figler BD, Hoffler CE, Reisman W, Carney KJ, Moore T, Feliciano D. Multi-disciplinary update on pelvic fracture associated bladder and urethral injuries. Injury 2012;43:1242-9.
    Pubmed CrossRef
  2. Haas CA, Brown SL, Spirnak JP. Limitations of routine spiral computerized tomography in the evaluation of bladder trauma. J Urol 1999;162:51-2.
    Pubmed CrossRef


April 2019, 9 (1)
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