We report the case of a 50-year-old woman diagnosed with a poorly differentiated solid urothelial carcinoma of high grade, with irregular lamina propria and muscularis.
A detubulized radical cystectomy and sigmoidostomy (Mainz II) were performed. Both ureters were implanted in the left lateral side of the pouch with placement of catheters exiting by counterincision.
Ten days after surgery the patient began with abdominal pain in the right flank with signs of peritoneal irritation associated with leukocytosis.
Subcutaneous migration of left catheter was observed.
Urgent CT is performed identifying the pigtail-type catheter with its rhizome in the left renal pelvis that carries a normal course to the anterior part of the neobladder, always going through the posterior part and presenting a superficial ascending line.
The tip is located immediately posterior to the right anterior abdominal rectus muscle.
No extraoral air bubbles are seen suggesting perforation.
The emergency situation is established, introducing the end to 20 cm of anal margin.
At this level, a neobladder catheter was placed in the bladder neck with exit through the posterior wall, without identifying the distal end.
The catheter was removed with an uneventful clamp, and the patient subsequently showed good clinical evolution, with disappearance of abdominal pain, and was discharged 48 hours after the procedure.
