Spontaneous Perinephric Urinoma after the Removal of a Foley Catheter in a Girl with Acute Kidney Injury

Urinomas can occur after renal trauma or perforation of the collecting system during an endosurgical procedure. However, spontaneous urinomas are very rare. Here we report a case of a spontaneous perinephric urinoma following the removal of a Foley catheter in an 18-year-old girl with acute kidney injury caused by septic shock. The patient had been treated for septic shock, acute kidney injury, and acute respiratory distress syndrome, and had a Foley catheter in place for seven days. After Foley catheter removal, the patient complained of consistent voiding difficulty. An abdominal computed tomography scan showed a large amount of left perinephric fluid, and the aspirated fluid included urothelial cells, confirming the diagnosis of a urinoma. The urinoma was successfully treated by insertion of a double-J stent into the left ureter. This report discusses the available literature on urinomas, and their clinical features, diagnosis, and treatment.

Feasibility of Foley Catheter Prior to Endoscopy for the Removal of Esophageal Coin in Children / 대한소아소화기영양학회지

PURPOSE: This study evaluated the efficiency and safety of the Foley catheter for esophageal removal of coins in children, compared to standard endoscopic extraction with respect to success rate, sedation, promptness and cost. METHODS: Twenty four children with coin lodgement in esophagus were managed with either a Foley catheter (n=14) or endoscopic extraction (n=10) from January 2007 through August 2010 at Kyungpook National University Hospital. A retrospective review of medical records and radiological findings was performed. RESULTS: Of the 14 patients who underwent Foley catheter extraction, successful and complication-free removal was achieved in 10 cases (71.4%). Of the 10 patients who underwent endoscopic extraction, all cases were successful (p=0.114). Sedation rate in the Foley catheter and endoscopic extraction group was 6/14 and 10/10 (p=0.006). The average wait time before the procedure and average hospital charge (US$) were 2.0+/-1.1 hours and 18.1+/-13.7 hours, and $113 and $428 for Foley catheter extraction and endoscopic extraction, respectively. CONCLUSION: Foley catheter extraction may be tried for the removal of esophageal coins in uncomplicated children. The technique is effective, safe, inexpensive and free of general anesthesia.

Management of Anastomotic Leakage after Gastrointestinal Surgery Using Fluoroscopy-guided Foley Catheter

PURPOSE: The aim of this study is to present cases of postoperative leakage after various types of gastrointestinal operations that were successfully managed with fluoroscopy-guided Foley catheter. METHODS: Fluoroscopy-guided Foley catheter insertion and drainage methods were performed in 13 leakage sites of 10 patients diagnosed as having leakage after gastrointestinal operations such as esophagectomy, gastrectomy and appendectomy. Under fluoroscopic guidance, a guide-wire was inserted into the leakage site where a Foley catheter was then introduced over the guide wire, inserted and ballooned. RESULTS: The median time for the procedures was 30 minutes (range: 20~260 minutes), with esophagus or stomach leakage sites requiring a longer procedure time than the appendiceal or duodenal stump. The indwelling Foley catheters were successfully removed after a median of 11 days (range: 8~44 days), and the opening of the enterocutaneous fistulas were spontaneously closed in eight out of 10 patients. CONCLUSION: The application of this method showed good results and could be a useful method to manage leakage after gastrointestinal surgery, especially in patients with leakage from the stump of the duodenum or appendix.