Bladder Perforation from Foley Catheter Insertion in a Middle-Aged Man in the Emergency Department

Abstract

Iatrogenic bladder perforation secondary to foley catheter insertion is extremely rare and the incidence is difficult to define. Bladder rupture in general is a serious, rare complication that can lead to high morbidity and mortality if not recognized and managed timely. In an attempt to summate information for this case report, risk factors for bladder injury in a newly placed foley were investigated and are variable. In this discussion, we present a 48-year-old male gentleman who was diagnosed with a bladder perforation after foley catheter insertion in the emergency department for management of urinary retention. After insertion, there was prompt return of 1000mLs of bloody urine. Computed tomography was performed showing the tip of the catheter penetrating through the dome of the bladder. X-ray cystogram confirmed the diagnosis. The patient subsequently underwent repair of the perforation. The postoperative course was uncomplicated, and the patient recovered well. Bladder perforations can be associated with high morbidity and mortality. Prompt recognition and treatment is imperative for improved patient outcomes. This case report is presented with the goal of describing the incidence, etiology, and management of an acute iatrogenic bladder injury with peritonitis.