Disclosures: Mark Linsenmeyer, MD: No financial relationships or conflicts of interest

Case Diagnosis: A 67-year-old with hemorrhagic stroke who presented with a retained Foley catheter in his gastrostomy tract.

Case Description: A patient presented with post-stroke dysphagia with a percutaneous endoscopic gastrostomy (PEG) tube. He was advanced to a regular diet with thin liquids. The initial plan was to pull the PEG after inpatient rehabilitation discharge in order to allow sufficient time for tract maturation, however at four weeks post-placement the patient pulled the tube out on his own. A weekend coverage team placed a 16 Fr Foley catheter through the tract to maintain patency. Multiple providers were subsequently unable to remove the Foley blindly, and fluid with the appearance of gastric contents was aspirated from the balloon’s port.

Setting: Acute inpatient rehabilitation hospitalAssessment/

Results: The Foley balloon was visualized by ultrasound and was noted to be in the stomach. It did not appear to inflate when >5cc of saline was placed into the balloon’s port. Subsequent aspiration from the same port produced about 3cc of light brown fluid with what seemed to be food particles, confirming suspicion that the balloon had ruptured. 5cc of 2% lidocaine jelly was then applied to the catheter at the stoma to lubricate the tract. The catheter was then removed entirely from the abdomen with gentle traction. Upon inspection of the catheter, the balloon was obviously popped, but the spherical shape of the balloon could be reapproximated by folding down its pieces, thus confirming no missing fragments.

Discussion: Temporarily replacing PEG tubes with Foley catheters is a common technique but is not without complications. One potential complication is a ruptured balloon. Use of ultrasound can aid in confirmation of rupture and subsequent safe removal.

Conclusion: In cases of Foley catheters that cannot be easily removed, whether in the stomach or in the bladder, ultrasound inspection of the balloon can assist with troubleshooting and safe removal.

Level of Evidence: Level V

« Back to AAPM&R Annual Assembly 2021

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/a-novel-method-for-removal-of-a-retained-foley-catheter-from-a-gastrostomy-tract-a-case-report/