Ureteral rupture from aberrant Foley catheter placement: A case report

Abstract

We present the case of a 59 year old female with history of severe neurologic dysfunction from advanced multiple sclerosis who presented with lethargy and oliguria several hours after urethral Foley catheterization.  A contrast-enhanced CT scan of the abdomen/pelvis showed an aberrantly placed Foley catheter with its balloon inflated in the proximal left ureter, a rare complication of Foley catheterization with only 5 other cases reported.  Incomplete ureteral rupture was demonstrated and confirmed by a followup CT scan in the urographic phase.  One of our institution's Interventional Radiologists then placed a nephroureteral stent across the injured ureter to facilitate healing.  The patient expired 9 days after the procedure from unrelated sepsis from a chronic stage IV decubitus ulcer, so long term monitoring could not be performed.  Following description of our case, we conduct a literature review of presentations, imaging characteristics, and treatment of ureteral Foley catheter placement.