Foley catheter through a colovesical fistula: an unusual method of diagnosis.

To cite: Pindoria K, Reyad A, Youssef Y. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014204968 DESCRIPTION An 89-year-old woman with a known history of diverticulitis presented to our emergency department (ED) with a few days’ history of haematochezia. She had decided to seek medical help after having a severe episode of bloody stool and feeling dizzy. Her vital signs were normal, and her physical examination disclosed mild left lower quadrant tenderness but no peritoneal signs. Given her presentation, she was resuscitated according to protocol, which included the insertion of a Foley catheter by the ED staff. The patient was then taken to the radiology department for a CTscan of the abdomen and pelvis. Afterwards she was brought back to her ED room, where it was noticed that her urine bag contained a dark green, stool-like thick fluid. Upon further examination, the bag did indeed contain loose stool but had no evidence of blood. When her CT scan was reviewed, it was obvious that the patient had a large colovesical fistula which resulted from her diverticular disease, manifested by the passage of the Foley catheter into the colon (figure 1) through the fistulous tract (figure 2). As the patient was not septic and was stable haemodynamically, the Foley’s balloon was deflated and the catheter was removed completely. A detailed past medical history revealed that the patient had been treated three times in the past 2 years for urinary