Acute ureteral obstruction from buckshot

Clinical management of foreign bodies of the genitourinary tract

PURPOSE

The variety of foreign bodies inserted into or externally attached to the genitourinary tract defies imagination and includes all types of objects. The frequency of such cases renders these objects an important addition to the diseases of the urinary organs.

MATERIALS AND METHODS

We performed a computerized MEDLINE search followed by a manual bibliographic review of cross-references. These reports were analyzed and the important findings summarized.

RESULTS

Our review encompassed approximately 800 single case reports on foreign bodies in the English world literature published between 1755 and 1999. We structured the range of introduced objects, by referring to origin and material as well as the genitourinary organs involved. Furthermore, we noted symptomatology and diagnoses, including psychological involvement, as well as possible treatment options.

CONCLUSIONS

The most common motive associated with foreign bodies of the genitourinary tract is sexual or erotic in nature. The most suitable method of removing a urethral foreign body depends on the size and mobility of the object applied to the genitourinary tract. When possible, endoscopic and minimal invasive techniques of removal should be used. However, surgical retrieval of a foreign body may be required, particularly when there is a severe associated inflammatory reaction.

Buckshot colic: case report and review of the literature

Three weeks after a shotgun wound to the chest and abdomen, a patient developed acute ureteral colic caused by a migrating shotgun pellet. The pellet passed spontaneously. A search of the literature revealed 25 similar cases of this unusual complication of missile injuries to the abdomen. These cases are reviewed and analyzed. Ureteral obstruction from migrating retained missiles is an unusual complication of missile injuries to the abdomen. Cases have been described occurring after shotgun, gunshot, and shrapnel wounds. Cases involving bullets and shrapnel fragments usually have had long latent periods after the initial injury and required surgery to remove the obstructing projectile. In contrast, cases of "buckshot colic" from shotgun pellets present earlier and often resolve with spontaneous passage of the pellet. The following report illustrates how conservative management can be successful in cases of "buckshot colic."

Serial sonographic evaluation of "buckshot colic" following a penetrating gunshot wound

This paper demonstrates the findings of various radiologic imaging modalities in a case of shotgun injury to the kidney. This case is unusual because buckshot entered the renal collecting system, and subsequently passed through the urinary tract in the urine, causing "bullet colic." References to such injury in the literature are discussed, along with role of each imaging modality in the initial and subsequent radiologic workup, with particular emphasis on the usefulness of ultrasonography in evaluation of this patient.

Bullet colic

Ureteral obstruction by intramural bullet, buckshot, or related missle following penetrating abdominal trauma is rare; a search of the literature revealed only 4 previously described cases [1-4]. A fifth case of a bullet migrating from the renal pelvis to the ureter has been reported at autopsy [5]. We present 2 new cases of delayed symptomatic ureteral obstruction ("bullet colic") after abdominal gunshot wounds.

Buckshot colic

A patient with a shotgun injury to the abdomen and kidney with delayed spontaneous ureteral passage of a shotgun pellet is reported. This rare complication "buckshot colic" usually can be treated nonoperatively. The term "buckshot colic" is clarified.

Ureteral obstruction by shotgun pellet seven years after injury

Ureteral obstruction by an extrinsic object is rare. We herein report a case of renal colic caused by a shotgun pellet lodged in the ureter seven years after the injury. Computerized tomography scan and antegrade pyelogram demonstration were obtained.