Occult transfixation of the sigmoid colon by suprapubic catheter.

PRESENTATION A 75-year old man with severe cerebrovascular disease underwent a routine change of suprapubic catheter three months after first insertion. One day after the catheter was changed, he passed faeculent material in the catheter and became unwell with abdominal pain. The catheter tip was visible per rectum. OUTCOME A CT scan confirmed that the suprapubic catheter had passed into the sigmoid colon. He underwent laparotomy and repair of a colovesical fistula and sigmoid perforation. He made an uncomplicated recovery. CONCLUSION Damage to the bowel is a rare but recognized complication of suprapubic catheter insertion. Our patient illustrates that the injury may not become apparent until a change of catheter, and clinicians should bear in mind the possibility of occult bowel damage if patients become unwell after a change of suprapubic catheter.