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August 16, 1976

Foley Catheter Perforation of the Urinary Bladder

Author Affiliations

The Rokach Municipal Hospital Tel Aviv, Israel

JAMA. 1976;236(7):822. doi:10.1001/jama.1976.03270080014014

To the Editor.—  The following case is a remainder of an uncommon complication of long-term catheterization of the urinary bladder.

Report of a Case.—  A 71-year-old woman was admitted to the hospital because of an obtunded abdomen and shock. Her medical history included diabetes mellitus and atherosclerotic vascular disease. Urinary incontinence after a stroke necessitated the insertion of a permanent Foley catheter one year before hospitalization.On admission, the patient's temperature was 38.7 C, her blood pressure was unobtainable, and her abdomen was tense and tender. An abdominal roentgenogram showed gastric dilatation and free air in the retroperitoneal space. The urine present in the catheter lumen contained numerous erythrocytes and leukocytes, but it soon became apparent—despite vigorous treatment that included fluids, antibiotics, and steroids—that the patient was anuric.Abdominal puncture did not disclose any fluids. Because of the patient's poor condition and failure to respond to supportive measures, surgery was