An 89-year-old woman kept returning to the hospital with urinary infections that had spilled into her bloodstream. Antibiotics cleared each episode. Then another one arrived. The cause was not in her urinary tract at all. It was a chicken bone she had swallowed at some point, wedged in her sigmoid colon and pressing hard enough on the neighboring ureter to back urine up into her left kidney.
Radiologists described the case in the August issue of Radiology Case Reports, an open-access journal published by Elsevier. A computed tomography scan showed the bone sitting in the lower colon and compressing the left distal ureter from the outside, producing chronic obstructive uropathy and the swollen, urine-filled kidney and ureter that doctors call hydroureteronephrosis. An interventional radiology team placed a nephroureteric stent, which resolved the obstruction.
The detail that makes the case worth reading is the anatomy. Nothing punctured anything. The bone never entered the urinary system. It simply parked itself in a stretch of bowel that runs within millimeters of the ureter, and it squeezed.
Two Systems That Never Connect but Sit Uncomfortably Close
The ureters are narrow muscular tubes, roughly the diameter of a coffee stirrer, that carry urine from each kidney down to the bladder. On their way through the pelvis, they pass alongside the sigmoid colon, the S-shaped final bend of the large intestine. Under normal conditions, that proximity is irrelevant. Add a rigid object inside the bowel and a stretch of intestinal wall thickened by inflammation, and the proximity starts to matter.
When a ureter is squeezed, urine stops draining freely. Stagnant urine is more easily colonized by bacteria, and an infection that would otherwise stay in the bladder can spread to the kidney and then into the bloodstream. That progression is why this patient's problem announced itself as repeated bouts of urosepsis and bacteremia rather than as abdominal pain. The National Kidney Foundation lists urinary tract infections among the common infections that can lead to sepsis, and the Sepsis Alliance describes sepsis as a medical emergency requiring rapid diagnosis and treatment.
Antibiotics can clear each episode. They cannot fix the plumbing. Until someone finds the obstruction, the infections keep coming back.
Most People Have No Idea They Swallowed Anything
Swallowing a bone fragment is common. Serious trouble from it is not. Surgeons writing in Case Reports in Surgery noted that the vast majority of swallowed foreign bodies pass through the gut uneventfully within about a week, and that fewer than 1% of patients develop complications such as perforation.
The complication rate is low. The recall rate is lower still. In a review of liver abscesses caused by migrating foreign bodies, published in Autopsy and Case Reports, surgeons reported that more than 90% of those patients did not remember swallowing anything, with fish bones, chicken bones, and toothpicks the objects found most often. That is a diagnostic trap. Doctors taking a history get a flat denial, because the patient is telling the truth as they know it.
When bones do cause damage, they tend to do it in predictable places. Surgeons writing in Cureus about a related case reported that perforation from a swallowed object most often occurs in the ileum, the rectosigmoid colon, and the narrowest segments of bowel, including the ileocecal valve and the rectosigmoid junction, and that diverticular disease leaves the colon more vulnerable. Those same authors described an 82-year-old woman in the United Kingdom whose swallowed chicken wishbone perforated her sigmoid colon and produced a pelvic collection that pressed on her ureter, causing hydronephrosis on the right side. Different mechanism, similar downstream result.
Why the Scan Did the Work Here
Poultry and fish bones are notoriously hard to see on plain X-ray. The Cureus authors stressed that computed tomography is essential for confirming the diagnosis and guiding surgery. A separate case report in the Journal of Medical Case Reports noted that free gas, the classic X-ray sign of a perforation, shows up in only about 20% of patients.
In this case, CT turned a vague pattern of repeat admissions into a specific, fixable finding. The stent restored drainage without surgery, which is particularly important for a patient approaching 90 with recurrent bloodstream infections.
What This Does and Does Not Mean for Readers
This is a single case report. It describes what happened to one patient and says nothing about how often swallowed bones compress ureters, which is almost certainly rare enough that most urologists will never see it. Nobody should read this and start worrying about chicken dinners.
The useful takeaway is narrower and aimed mostly at clinical thinking. Repeated urinary infections in an older adult are not always a urinary problem. When infections keep returning despite appropriate antibiotics, something structural is often obstructing flow, and the cause may sit outside the urinary tract entirely.
Anyone experiencing repeated urinary infections, fever with flank pain, or symptoms that return quickly after antibiotics should raise that pattern with a clinician rather than treating each episode in isolation. Sudden severe abdominal pain, high fever, confusion or a racing heart after an infection warrants urgent medical attention.
Key Questions Answered
What actually happened to this patient?
A chicken bone she had swallowed lodged in her sigmoid colon and pressed on the left ureter from outside, blocking urine drainage. The backed-up urine led to repeated kidney infections that spread into her bloodstream.
How was it found?
A CT scan of the abdomen and pelvis showed the bone in the colon and the swollen ureter and kidney above the compression point. Poultry bones are frequently invisible on plain X-ray.
How was it treated?
An interventional radiology team placed a nephroureteric stent to reopen drainage, which resolved the obstruction without open surgery.
Is this a common risk from eating chicken?
No. Swallowed bones almost always pass without incident, and fewer than 1% of people who swallow a foreign object develop complications such as perforation. External compression of a ureter is rarer still.
Why did she not remember swallowing a bone?
Most people do not. In one review of foreign-body liver abscesses, more than 90% of affected patients had no recollection of the ingestion.
What warning signs matter here?
Urinary infections that keep coming back after treatment, especially when accompanied by fever or flank pain, can signal an obstruction. That pattern is worth flagging to a clinician rather than treating episode by episode.
