• Barbara Rampersad and Joanne F Paul.
• From the Faculty of Medical Sciences, The University of the West Indies, St Augustine. North Central Regional Health Authority, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
• Pediatr Emerg Care. 2024 Feb 1; 40 (2): 166168166-168.

AbstractThe spontaneous intravesicular knotting of a feeding tube used for urethral catheterization is a rare but documented complication. The reported incidence in the world literature is 0.2 per 100,000, with only 40 cases reported. Removal of these intravesicular knots has been attempted in a number of ways, such as the use of a guide wire to untangle the knot, use of excess lubrication and traction with or without anesthetic, and percutaneous or open cystostomy. This cystoscopic technique for removal has not been previously described.Based on our experience and published recommendations, we formulate an algorithm for removal. We outline steps for prevention and techniques from simple to complex, which can be used to remove knotted catheters.Although a rare complication of catheterization in children, catheter knotting can be troublesome. Following the steps suggested in this algorithm may avoid the use of more invasive techniques for removal.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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