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An 81-year-old woman who had a long-term silicone suprapubic catheter (SPC) presented to hospital-few hours following a routine change of the catheter in the community-reporting drainage of a faeculent matter. The patient was clinically well. A suspicion of a colo-vesical fistula was raised and a CT scan of the abdomen and pelvis was carried out. The latter showed that the SPC was situated entirely outside the bladder with the tip of the catheter located inside the descending colon ( figures 1 and 2 ). Studying the CT scan images it became apparent that the catheter had not entered the bladder's cavity but rather it had eroded its way around the bladder and perforated the descending...