Distal migration of a jejunostomy Foley catheter across the ileocecal valve into the colon diagnosed on computed tomography: a case report

A Foley catheter is occasionally used for enteral feeding through a jejunostomy due to its availability and ease of placement. Although generally safe, catheter-related complications may occur. Intraluminal migration of a Foley catheter placed through an enterostomy site is rare, and distal migration across the ileocecal valve into the colon is exceedingly uncommon. We report the case of a 31-year-old female with a history of jejunal perforation managed surgically with exploratory laparotomy and double-barrel jejunostomy. During postoperative care, a 16 Fr Foley catheter was placed through the jejunostomy site for distal enteral feeding, with the balloon inflated using approximately 10 mL of sterile water and secured externally. Approximately 10 days after placement, the patient herself noticed and reported migration of the catheter into the distal bowel loop. As the proximal jejunostomy stoma remained functional, she was able to continue enteral feeding without difficulty and had no vomiting. The patient reported only mild abdominal discomfort with no other significant symptoms. Conservative observation was initially adopted and the patient was monitored for a few days with the expectation of spontaneous per rectal passage; however, this did not occur, likely due to impaction of the wide proximal end of the Foley catheter—which has two openings—at the ileocecal valve. Abdominal ultrasound demonstrated a rounded echogenic structure corresponding to the Foley balloon within the bowel lumen. Non-contrast CT of the abdomen clearly depicted the catheter coursing intraluminally through distal small bowel loops and crossing the ileocecal valve, with the balloon lodged within the ascending colon near the hepatic flexure. Multiplanar reformatted images delineated the entire catheter trajectory from the jejunostomy site to the colon. Surgical exploration confirmed the diagnosis. The catheter was retrieved via an enterotomy at the distal ileum, which was subsequently repaired with 3 − 0 Vicryl in four layers, without the need for bowel resection. This case highlights a rare but clinically significant complication of jejunostomy catheter migration and demonstrates the crucial role of cross-sectional imaging in diagnosis and surgical planning.