Intraperitoneal bladder perforation presenting as small bowel obstruction in a patient with a chronic indwelling catheter

Introduction: This case describes an unusual presentation of a bladder perforation following a routine catheter exchange in an elderly patient with a chronic indwelling foley catheter. Case Report: The patient presented with nausea, vomiting, and abdominal distension 10 days after routine exchange of his indwelling foley catheter. He was subsequently diagnosed with a small bowel obstruction. On imaging, he had a transition point at what was potentially the tip of the foley catheter protruding outside of his bladder versus the foley in a small bladder diverticulum. He ultimately required multimodal imaging, cystoscopy, and exploratory laparoscopy for diagnosis. Intraoperative findings ultimately demonstrated an intraperitoneal bladder perforation with the small bowel wrapped around the protruding foley catheter. Conclusion: Intraperitoneal bladder perforation can present without classic precipitating factors and should be on the differential diagnosis for a patient with bowel obstruction and a recent urinary catheter placement.