Suprapubic vesical catheter misplacement into ruptured iliac aneurysm

Abstract

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.