Acute Urinary Obstruction in a Tetraplegic Patient from Misplacement of Catheter in Urethra

Clinical Medicine Insights. Case Reports
Subramanian VaidyanathanBakul M Soni

Abstract

A male tetraplegic patient attended accident and emergency with a blocked catheter; on removing the catheter, he passed bloody urine. After three unsuccessful attempts were made to insert a catheter by nursing staff, a junior doctor inserted a three-way Foley catheter with a 30-mL balloon but inflated the balloon with 10 mL of water to commence the bladder irrigation. The creatinine level was mostly 19 µmol/L (range: 0-135 µmol/L) but increased to 46 µmol/L on day 7. Computerized tomography urogram revealed that the bilateral hydronephrosis with hydroureter was extended down to urinary bladder, the bladder was distended, prostatic urethra was dilated and filled with urine, and although the balloon of Foley catheter was not seen in the bladder, the tip of the catheter was seen lying in the urethra. Following the re-catheterization, the creatinine level decreased to 21 µmol/L. A follow-up ultrasound scan revealed no evidence of hydronephrosis in both kidneys. Flexible cystoscopy revealed inflamed bladder mucosa, catheter reaction, and tiny stones. There was no bladder tumor. This case report concludes that the cause of bilateral hydronephrosis, hydroureter, and distended bladder was inadequate drainage of urinary bladder as the F...Continue Reading

References

Jan 23, 2014·Patient Safety in Surgery·Subramanian VaidyanathanKamesh Pulya
May 31, 2014·Journal of the American Society of Nephrology : JASN·Samira BellPeter T Donnan
Aug 26, 2014·The Journal of Thoracic and Cardiovascular Surgery·Dorthe Viemose NielsenCarl-Johan Jakobsen
Nov 8, 2014·BMJ Case Reports·Vaidyanathan SubramanianGurpreet Singh
Nov 28, 2014·The Journal of the American Osteopathic Association·Michelino Mancini, Alex Spiewak

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