Urinary Bladder Perforation Due to Foley Catheter: A Case Report and Review of Literature

Urinary bladder perforation is one of the few surgical emergencies prone to misdiagnosis, leading to a high mortality rate. Our case highlights patient management in such cases and reviews similar reports to increase awareness about patients with indwelling catheters and suspicion of bladder perforation. A 73-year-old patient with decompensated heart failure developed severe abdominal pain, abdominal distention, and hematuria following a Foley catheter insertion. Computed tomography (CT) raised suspicion of bladder perforation. Exploratory laparotomy revealed serosanguinous fluid in the abdomen and rupture of the bladder dome. Bladder repair was performed, and the patient was monitored post-operatively under intensive care, with an uneventful recovery before discharge. There are many causes of bladder perforation. It occurs most commonly due to traumatic incidence, iatrogenic instrumentation, or spontaneous rupture. It is a rare complication, accounting for 0.002% of all hospital admissions. According to the Centers for Disease Control (CDC), 12-15% of patients receive a urinary catheter during their hospital stay; therefore, it is important to consider complications of catheterization and their management. Bladder rupture can present with non-specific symptoms leading to delayed management. We recommend clinical attention to patients with urinary catheter insertion presenting with severe abdominal pain, difficulty voiding, or hematuria to rule out the possibility of perforation. Rapid diagnosis and accurate treatment of such cases are crucial for an uneventful recovery.