Suprapubic vesical catheter misplacement into ruptured iliac aneurysm

Background

Isolated iliac aneurysms are difficult to diagnose. In this unique case report, we present an unusual incident in which the diagnostic for a ruptured iliac aneurysm was unexpectedly initiated through the misplacement of a suprapubic catheter.

Methods

We retrospectively collected patient's data, medical history and imaging using our electronic data base. The consent of the patient family was collected.

Result

We report a case of a ruptured iliac aneurysm that clinically imitated urinary retention with hemodynamic shock, the misdiagnosis caused insertion of a suprapubic catheter into the iliac aneurysm. Following active bleeding through the catheter, a CT-scan was immediately performed and retrieved the ruptured iliac aneurysm. The patient underwent immediate surgery consisting of aorto-bi-femoral bypass. No complications occurred during the post-operative course and follow-up. Fortunately, the vessel trauma was without major consequences for the patient as the catheter was left in place and clamped before surgery.

Conclusion

We report a case of a ruptured iliac aneurysm that clinically imitated urinary retention with hemodynamic shock with insertion of a suprapubic catheter into the iliac aneurysm successfully treated by aorto-bi-femoral bypass. Isolated iliac aneurysms are a relatively rare, they remain asymptomatic and are mostly discovered by chance. We recommend an ultrasonography screening before the insertion of a suprapubic catheter, especially for patients at-risk, to avoid bleeding caused by potential vascular trauma.