Cullivan Orla, David Silviu, Jaffry Syed
Department of Urology, Galway University Hospital, Galway, Ireland.
Case Rep Urol. 2022 Jun 15;2022:8656233. doi: 10.1155/2022/8656233. eCollection 2022.
A 79-year-old gentleman presented to the Emergency Department (ED) with catheter-related issues on a background of a long-term catheter for previous urinary retention, Hartmann's procedure for colorectal cancer, and brachytherapy for prostate cancer. A 3-way silicone catheter was placed by ED staff and bladder irrigation commenced. The urine draining following catheterisation was found to be dark and thick, and irrigation fluid was noted to be draining per rectum. CT imaging was performed and demonstrated the catheter tip extending through the posterior wall of the urethra and into the rectum. The patient was admitted under the urology team, and urinary diversion was achieved with a suprapubic catheter. Subsequent imaging demonstrated a periprostatic abscess, which was initially managed with antimicrobial therapy, followed by attempted image-guided drainage. Repeat imaging following a 6-week course of antibiotics failed to show an improvement in the collection. During his inpatient stay, he contracted COVID-19 and passed away suddenly. This case demonstrates the potential catastrophic consequences associated with urethral catheterisation.
一名79岁男性因导管相关问题就诊于急诊科，其有长期留置导尿管史，曾因结直肠癌接受哈特曼手术，因前列腺癌接受近距离放射治疗。急诊科工作人员置入了一根三腔硅胶导尿管并开始膀胱冲洗。导尿后引出的尿液呈深色且浓稠，发现冲洗液经直肠引出。进行了CT成像，显示导管尖端穿过尿道后壁进入直肠。患者由泌尿外科团队收治，通过耻骨上导管实现了尿流改道。后续成像显示前列腺周围脓肿，最初采用抗菌治疗，随后尝试在影像引导下引流。使用抗生素治疗6周后重复成像显示积液无改善。住院期间，他感染了新冠病毒并突然去世。该病例显示了尿道插管可能带来的灾难性后果。
