Figure 1.

Inadvertent transcolonic catheter placement. A 54-year-old woman presented for drainage of a diverticular abscess. (A) Preliminary CT showed localizing needle placed in fluid collection within the left paracolic gutter next to an adjacent bowel loop. (B) Wire successfully coiled within collection, avoiding bowel loop. (C) CT following catheter placement showed inadvertent placement within the bowel loop during serial dilatation and “blind” catheter placement. (D) Contrast injection confirmed catheter placement within the colon. A second catheter had been placed into the fluid collection. As this patient was a poor surgical candidate, the malpositioned catheter was left in place to allow a cutaneous fistula to develop. (E) Contrast injection of the enteric catheter demonstrated position within the colon. After the fluid collection was completely drained, the second catheter was removed. The originally malpositioned catheter was injected to rule out spillage of contents into the adjacent collapsed cavity. Following the development of a mature tract, the colonic catheter was removed.