Imaging description

A Foley bladder catheter without visualized surrounding bladder is usually due to bladder rupture and extraluminal location of the catheter. However, a similar appearance can occur with a collapsed bladder (Figure 76.1).

On a pelvic CT, distal portions of a urinary catheter may be visualized in the pelvis without evidence of surrounding urine or bladder. Findings may be suggestive of an extraluminal catheter location, usually secondary to bladder rupture.

While initial review of images may suggest an extraluminal catheter location, careful evaluation of the bladder and catheter may confirm an intraluminal location. Multiplanar reformations are helpful and sometimes essential to adequately evaluate the catheter tip position. Moreover, if the patient is being evaluated following trauma, they are also useful to confirm a normal bladder or diagnose bladder injuries [1]. If the catheter position cannot be resolved following careful review of all images, additional evaluation may be necessary.

If the patient is not at risk for bladder injury and CT cystography (CTC) is not indicated for other reasons, lowdose delayed images with a clamped and adequately distended bladder will usually clearly demonstrate the catheter location within the bladder.