Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2020; 8(20): 4993-4998
Published online Oct 26, 2020. doi: 10.12998/wjcc.v8.i20.4993
Bladder perforation caused by long-term catheterization misdiagnosed as digestive tract perforation: A case report
Bin Wu, Jing Wang, Xu-Jian Chen, Zhong-Cheng Zhou, Ming-Yuan Zhu, Yi-Yu Shen, Zheng-Xiang Zhong
Bin Wu, Jing Wang, Xu-Jian Chen, Zhong-Cheng Zhou, Ming-Yuan Zhu, Yi-Yu Shen, Zheng-Xiang Zhong, Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Author contributions: Wu B and Shen YY participated in the design of the report, analyzed the data and wrote the paper; Wang J, Chen XJ and Zhu MY collected the medical imaging materials; Zhou ZC and Zhong ZX designed the report and performed the preliminary revision of the article.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yi-Yu Shen, MD, Chief Doctor, Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Jiaxing University, No. 1518 Huancheng North Road, Jiaxing 314000, Zhejiang Province, China. jxeysyy01@163.com
Received: July 15, 2020
Peer-review started: July 15, 2020
First decision: August 8, 2020
Revised: August 10, 2020
Accepted: September 16, 2020
Article in press: September 16, 2020
Published online: October 26, 2020
Processing time: 103 Days and 0.4 Hours
Abstract
BACKGROUND

Spontaneous bladder rupture is relatively rare, and common causes of spontaneous bladder rupture include bladder diverticulum, neurogenic bladder dysfunction, gonorrhea infection, pelvic radiotherapy, etc. Urinary bladder perforation caused by urinary catheterization mostly occurs during the intubation process.

CASE SUMMARY

Here, we describe an 83-year-old male who was admitted with 26 h of middle and upper abdominal pain and a history of long-term catheterization. Physical examination and computed tomography of the abdomen supported the diagnosis of diffuse peritonitis, most likely from a perforated digestive tract organ. Laparoscopic exploration revealed a possible digestive tract perforation. Finally, a perforation of approximately 5 mm in diameter was found in the bladder wall during laparotomy. After reviewing the patient’s previous medical records, we found that 1 year prior the patient underwent an ultrasound examination showing that the end of the catheter was embedded into the mucosal layer of the bladder. Therefore, the bladder perforation in this patient may have been caused by the chronic compression of the urinary catheter against the bladder wall.

CONCLUSION

For patients with long-term indwelling catheters, there is a possibility of bladder perforation, which needs to be dealt with quickly.

Keywords: Bladder perforation; Catheterization; Misdiagnosed; Case report

Core Tip: Here, we describe a patient, who had a long-term indwelling catheter and complained of abdominal pain, with a bladder perforation that was mistaken for a gastrointestinal perforation. We found that 1 year prior the patient underwent an ultrasound examination showing that the end of the catheter was embedded in the mucosal layer of the bladder. Therefore, the bladder perforation in this patient may have been caused by the chronic compression of the urinary catheter against the bladder wall. This case reminds us that for patients with long-term indwelling catheters, bladder perforation may occur and needs to be dealt with timely.