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Diagnosis of acute abdomen in spinal cord injury (SCI) patients remains challenging. Classic peritoneal signs, such as rigid abdomen, rebounding pain and abdominal muscle guarding may be not reliable. It is still an important cause of morbidity and mortality in patients with SCI. A 45-year-old woman with SCI and 7th and 8th thoracic vertebrae fractures suffered from lower abdominal pain, fever and chills for three days. Physical examination revealed diffuse abdominal tenderness with muscle guarding. Laboratory studies showed severe leukocytosis and mild pyuria. Abdominal contrast-enhanced computed tomography scans (CTS) revealed a urinary catheter, which had been accidentally inserted into the right ureter through the ureteral orifice. Abdominal pain improved dramatically after the urinary catheter was replaced. We suggest further workup for possible causes of acute abdominal pain in SCI patients presenting with symptoms such as vomiting, vague abdominal pain, abdominal distension, spasms and cramps. Early investigation with abdominal X-ray, ultrasound, computed tomography scan or diagnostic video laparotomy may prevent delays in diagnosis and improvement of outcome.

rehabilitation practice and science

Acute Abdominal Pain in Spinal Cord Injury Patient Induced by Indwelling Urethral Catheter Placed into the Right Ureter through the Ureteral Orifice: A casereport