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06 October 2015 : Case report  India

Fecal Fistula Communicating with a Femur Shaft Fracture Secondary to a Malpositioned Suprapubic Catheter: A Case Report

Unusual clinical course, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Clinical situation which can not be reproduced for ethical reasons

Uday GuledE, Vijay G. GoniA, Arjun R.H. HonnurappaB, Rakesh JohnD, Harsha VardhanaA, Gaurav SharmaF, Kirubakaran S. PattabhiramanG

DOI: 10.12659/AJCR.894516

Am J Case Rep 2015; 16:711-714

Abstract

BACKGROUND: Suprapubic catheter (SPC) insertion is a common urological procedure. Though considered a simple and safe procedure, complications are bound to occur if proper precautions are not taken during the procedure. The reported complications include gross hematuria, post-obstruction diuresis, insertion site skin-related complications, and intra-abdominal visceral injuries. Iatrogenic bowel injuries have been reported to occur as a complication in around 2.5% of cases.

CASE REPORT: We report a very rare case of a bowel injury due to improper insertion of a SPC leading to fecal matter tracking along the muscle planes to reach the fracture site of the femur shaft and formation of an external fecal fistula along the lateral aspect of thigh, which according to us is the first reported case in the literature.

CONCLUSIONS: This case report shows the devastating complication of a technically simple procedure done in an improper manner and successful management of a rare case of femur fracture with communicating fecal fistula. The purpose of this case report is to highlight the importance of taking proper precautions before the procedure.

Keywords: Colon - injuries, Adolescent, Cutaneous Fistula - etiology, Equipment Failure, Feces, Femoral Fractures - diagnosis, Intestinal Fistula - etiology, Intestinal Perforation - radiography, Radiography, Abdominal, Thigh, Urinary Catheters - adverse effects

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923