Two Cases of Bladder Perforation Associated with an Indwelling Urethral Catheter

Abstract

We report herein on two cases of bladder perforation caused by an indwelling urethral catheter. [Case 1] A 72-year-old male visited our hospital complaining of abdominal pain. He had undergone a resection of an allantoic duct abscess 12 years prior, and had received an indwelled urethral catheter 1 month prior for a vesicocutaneous fistula. Abdominal computed tomography (CT) revealed dilation of the small intestine and ascites. A physical examination revealed peritoneal irritation signs. We diagnosed acute generalized peritonitis and performed emergency surgery. Intraoperative findings revealed a paralytic ileus that was caused by bladder perforation and we performed intraperitoneal irrigation drainage and sutured the perforation site closed. [Case 2] An 86-year-old woman had received an indwelled urethral catheter 9 months prior owing to a neurogenic bladder. She complained of abdominal pain and had a fever. We diagnosed perforating peritonitis based on an abdominal enhanced CT and performed emergency surgery. Intraoperative findings revealed panperitonitis that was caused by bladder perforation and we performed intraperitoneal irrigation drainage and sutured the perforation site closed. We experienced two cases in which we suspected gastrointestinal disease, but the final diagnosis was a bladder perforation. While a bladder perforation is rare, we should remember that it can cause acute abdominal problems.