title: Fecal Fistula Communicating with a Femur Shaft Fracture Secondary to a Malpositioned Suprapubic Catheter: A Case Report.
abstract: BACKGROUND
  Suprapubic catheter (SPC) insertion is a common urological procedure. Though considered a simple and safe procedure, complications are bound to occur if proper precautions are not taken during the procedure. The reported complications include gross hematuria, post-obstruction diuresis, insertion site skin-related complications, and intra-abdominal visceral injuries. Iatrogenic bowel injuries have been reported to occur as a complication in around 2.5% of cases.
  
  
  METHODS
  We report a very rare case of a bowel injury due to improper insertion of a SPC leading to fecal matter tracking along the muscle planes to reach the fracture site of the femur shaft and formation of an external fecal fistula along the lateral aspect of thigh, which according to us is the first reported case in the literature.
  
  
  CONCLUSIONS
  This case report shows the devastating complication of a technically simple procedure done in an improper manner and successful management of a rare case of femur fracture with communicating fecal fistula. The purpose of this case report is to highlight the importance of taking proper precautions before the procedure.
authors.affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Uday
authors.initials: U
authors.lastname: Guled
authors.affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Vijay G
authors.initials: VG
authors.lastname: Goni
authors.affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Arjun R H
authors.initials: AR
authors.lastname: Honnurappa
authors.affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: John
authors.affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Harsha
authors.initials: H
authors.lastname: Vardhana
authors.affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Sharma
authors.affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Kirubakaran S
authors.initials: KS
authors.lastname: Pattabhiraman
mesh_terms: D000293:Adolescent; D003106:Colon / Q000293:injuries*; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000209:etiology*; D004868:Equipment Failure; D005243:Feces; D005264:Femoral Fractures / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology*; D007416:Intestinal Perforation / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D011860:Radiography, Abdominal; D013848:Thigh; D062885:Urinary Catheters / Q000009:adverse effects*