So I wanted to get some opinions on this. I had a pt today come to the ER that we had to intubate. He presented with an indwelling cath that was placed at another hospital a few days prior. Pt had been dx with a UTI at that time and, I'm assuming, urinary retention. Pt presented to us in septic shock. Urine in the foley bag was dark brown with no sediment, much like the color of urine seen in rhabdomyolysis. I obtained a urine sample from the foley bag and sent to lab.
A bit later, lab calls me and informs me that the urine was contaminated with stool. I had never heard of urine from a foley being contaminated with stool and was wondering if anyone had come across this before.
A little more info: as I said, pt presented in septic shock. I put a new foley in and after an hour, only had about 20 ml of return. This time, the urine was clear yellow with lots of sediment. Once I got a gastric tube in, I immediately got 500 ml of light brown return with a remarkable amount of sediment. It seemed to me that the pt had a SBO as well, although I was never able to find out as he did not get his abdominal CT until he had gone to CCU.
An interesting theory one of the nurses proposed was that he had somehow perforated his bladder and/or bowel somehow and, along with the SBO, was spilling stool into his urine. Interesting theory, but I thought I'd get some opinions from the urology pros over here!