A 31-year-old woman recovering from bowel surgery noticed that the feeding tube in her abdomen had disappeared inward. A CT scan traced it through loop after loop of her small intestine, across the one-way valve guarding her colon, and into the ascending colon near her liver, where the inflated balloon on its tip had come to rest.
The case was published Aug. 31 in Discover Medicine by radiologists and surgeons at University College of Medical Sciences in Delhi. What makes it notable is not that a feeding tube moved. It is where the tube ended up, and the fact that the patient felt almost nothing while it happened.
The Patient Noticed It Before Anyone Else Did
She had undergone an exploratory laparotomy for a perforated jejunum, the middle section of the small intestine, and surgeons created a double-barrel jejunostomy, an opening through the abdominal wall with two limbs of bowel. The day after surgery, a 16 French Foley catheter was inserted through that opening for feeding, with its balloon inflated using roughly 10 milliliters of sterile water and the tube secured outside the body with a single non-absorbable stitch. No retention disc or other device was used.
Ten days later, the patient herself reported that the catheter had migrated into the bowel. She had mild abdominal discomfort and nothing else. No vomiting, no obstruction. Because the proximal limb of the jejunostomy still worked, she kept receiving nutrition without difficulty, which the authors credit with getting her to report the problem early.
Enteral feeding delivers nutrition directly into a working digestive tract and is standard care for people who cannot eat by mouth. Reference texts list tube dislodgment, malposition and intestinal obstruction among its recognized mechanical complications. Foley catheters are urinary devices rather than purpose-built feeding tubes, but hospitals use them this way because they are cheap, widely stocked and easy to place.
A One-Way Gate the Catheter Should Not Have Cleared
The ileocecal valve sits between the small and large intestine and normally prevents colonic contents from washing backward. Ultrasound first picked up a rounded echogenic structure in the right upper abdomen, consistent with the balloon.
Non-contrast CT then mapped the whole route. The catheter ran inside the bowel through the distal jejunum and ileum, crossed the ileocecal valve, and came to rest with its balloon in the ascending colon near the hepatic flexure. Multiplanar reconstructions traced the entire path from the stoma to the colon. There was no obstruction, no bowel wall thickening, no perforation and no leak at the stoma site.
The authors propose that peristalsis pushed the inflated balloon along like a lead point, helped by too much catheter inside the bowel and insufficient fixation outside it. They note that the valve is not an absolute mechanical barrier and that forward passage is possible under sustained peristaltic pressure.
Why the Tube Could Not Simply Pass Through
Doctors waited several days expecting the catheter to work its way out. It did not, and the reason comes down to the shape of the device.
The outer end of a standard Foley catheter, the part meant to stay outside the body, is wide and splits into two separate ports, one for drainage and one for inflating the balloon. That bulky forked end reached the narrowing at the ileocecal valve and stopped there. The balloon had already passed into the colon, so the catheter could travel no further forward and could not be expelled either.
This is not the first tube to make that journey. Doctors in Maryland reported a migrated feeding tube lodged at the ileocecal valve in a man with dementia, retrieved by colonoscopy after three days. Surgeons in Ecuador described a Foley catheter that migrated from a gastrostomy and caused acute bowel obstruction, and clinicians have reported a Foley gastrostomy tube dragging bowel into itself in an infant.
Here, gastroenterologists attempted colonoscopic retrieval and failed. Surgeons then opened the abdomen through a midline incision, made an opening in the distal ileum, pulled the catheter out and closed the bowel in four layers with absorbable sutures. No bowel was removed, and the recovery was uneventful. Two weeks after surgery she was symptom-free with normal bowel function.
The team argues for cutting into the ileum rather than the colon in cases like this, since it limits contamination and avoids the added risks of opening the large bowel.
What This Suggests for People Fed Through Surgical Tubes
The authors' broader point concerns hardware choice rather than a widespread danger. Purpose-designed enteral tubes, including mushroom-tip and low-profile devices, have tapered or collapsible ends and a uniform external profile, meaning they can usually pass on their own or be retrieved endoscopically if they migrate. A standard Foley cannot.
The limits here are real. This is one patient, and the report cannot establish how often this happens or which fixation methods prevent it. The authors also note that they operated openly rather than laparoscopically partly because of limited resources, which shapes how far the technique advice travels. Anyone with a feeding tube who notices it has shifted, shortened, or disappeared inward should contact their care team rather than attempting to reposition it.
Key Questions Answered
What happened to this patient? A Foley catheter placed through a surgical opening for feeding migrated inward over about 10 days, traveling through her small intestine and into her ascending colon, where its balloon lodged.
How did anyone find out? She noticed it herself and reported it. Ultrasound suggested the balloon's location, and a CT scan mapped the catheter's full path.
Was she in danger? She had only mild abdominal discomfort and no obstruction on imaging. The authors note that migration of this kind can lead to obstruction or perforation, which is why it needed to be resolved.
Why did surgery become necessary? The catheter's wide, two-port outer end could not fit through the ileocecal valve, so the tube could neither advance nor be expelled, and an attempt at colonoscopic retrieval failed.
Is this a common feeding tube complication? No. Migration of enteral tubes is uncommon, and passage across the ileocecal valve into the colon is described in the literature as exceedingly rare.
What should someone with a feeding tube watch for? Any change in the tube's external length or position, new abdominal pain, vomiting or a change in how feeds run. These warrant a call to the clinical team.
