Foreign bodies in the kidney; a review of the literature and reports of four additional cases

Needle as a Foreign Body in the Kidney of an Infant: A Case Report

Foreign bodies in the kidneys are extremely rare, particularly in pediatric patients. We report a unique case of a nine-month-old male infant who was incidentally found to have a needle in his left kidney during evaluation for a lower respiratory tract infection. The foreign body was initially identified on chest X-ray and confirmed by a computed tomography scan. The infant had a history of transient swelling in the left lumbar region during the neonatal period, which resolved spontaneously, suggesting a possible entry point. Despite being asymptomatic, surgical intervention was deemed necessary due to the metallic nature of the foreign body and its potential for complications. A laparoscopic approach was successfully used to remove the 3 cm needle, which was identified as a broken hypodermic injection needle. The kidney was preserved, and no postoperative complications were observed. The infant's recovery was uneventful, with normal renal function and imaging during follow-up. This case highlights the rarity of renal foreign bodies in infants, the effectiveness of laparoscopic surgery for their removal, and the importance of early recognition and timely intervention to prevent long-term complications. The report also discusses potential risks associated with outdated practices, such as the broken needle technique, which involves intentionally breaking a hypodermic needle for collecting blood samples from neonates and infants, and emphasizes the need for improved safety protocols and awareness in pediatric procedures.

Retrieval of intrarenal coiled and ruptured guidewire by retrograde intrarenal surgery: A case report and literature review

Background

Foreign bodies in the kidney have rarely been reported. However, they can be a clinical problem for urologists. We report on a patient with a residual segment of guidewire coating embedded in the renal parenchyma following computed tomography (CT)-guided percutaneous nephrostomy drainage (PCND), and our successful minimally invasive management with retrograde intrarenal surgery (RIRS).

Case presentation

A 40-year-old female with urosepsis due to a right upper ureteral stone with hydronephrosis received emergent CT-guided PCND and subsequent ureteroscopic lithotripsy, double J stent insertion, and percutaneous catheter removal. Follow-up radiography showed a coiled object within the upper pole parenchyma of the right kidney, which might be the remnant of a guidewire used during the PCND procedure. Flexible ureteroscopy (fURS) was performed. Under fluoroscopy, the foreign body was localized, the renal parenchyma was incised with laser, and the foreign body was retrieved using a stone basket.

Conclusion

Although guidewire breakage is uncommon, clinicians should keep it in mind during interventional procedures. Several methods can be used to eradicate foreign objects from the urinary tract, and the first choice should always be the least invasive one. RIRS with fURS is considered as a safe, efficient, and minimally invasive option for the extraction of foreign bodies from the kidney. To the best of our knowledge, this is the first comprehensive case report detailing the removal of a foreign object by RIRS in the English literature.

Removing a large sewing needle from the left kidney parenchyma using laparoscopic technique: A case report

We present case of left flank pain and a large sewing needle in the left kidney of a 34-year-old man, which was later removed using laparoscopic approach. To the best of our knowledge, our case appears to be the second case of its kind successfully treated using laparoscopic approach.

Chronic penetrating renal trauma due to iron wire ingestion: An unusual case report

Foreign body ingestion is a common presentation in the emergency room. However, the complication such as penetrating renal trauma due to sharp objects ingestion is relatively rare. We herein describe an unusual case of penetrating renal trauma in the absence of any other urinary symptoms. A 53-year-old man who had a history of iron wire ingestion went to our hospital, on examination, he only had slight abdominal tenderness due to swallowing a ball pen and 1 cap nut 1 day before, radiological imaging showed penetrating renal trauma, the blood test showed his renal function is normal. Surgical strategies were recommended to remove the pen and the iron wire simultaneously, nonetheless the patient eventually agreed to only receive surgical removal of the swallowed ball pen and cap nut, meanwhile leave the kidney untreated. During 30 months follow-up by phone and regular outpatient examination, he recovered unevenly and had no special complaint. Such cases remind us that chronic penetrating renal trauma due to foreign object ingestion may have no obvious symptoms. It is easily to be neglected. We should try to minimize the possibility of missed lesions by adhering to a meticulous examination technique.

A rare case of unusual migrated foreign bodies in kidney and their successful extraction using retrograde percutaneous nephrostomy

Foreign body ingestion is a common presentation in the emergency room and most cases are without any major symptoms, or go unnoticed and later cause severe complications that can potentially threaten patient life. We report a case of multiple migrated metallic foreign bodies in the right kidney presenting as right renal colic and gross haematuria one year after its accidental ingestion, treated successfully with retrograde percutaneous nephrostomy.

Foreign body in the kidney: an unusual case and its management

Encountering a foreign body (FB) in the kidney is uncommon. Most of the time a FB is introduced externally (violence or accident) or through endourological interventions. An ingested FB reaching the kidneys is extremely rare. This article includes an interesting case of FB, which apparently reached the kidney through the gastrointestinal tract as well as a brief review of the relevant literature. The case was successfully managed laparoscopically.

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."

Foreign body migration to the genitourinary tract

Foreign body migration from the gastrointestinal tract to any of several sites within the genitourinary tract has been well documented. We report 3 such cases involving the upper and lower urinary tract to highlight the varied presentations, manifestations and prognosis associated with this entity.

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.

Traveling bullets in genitourinary tract

A bullet lodged in the renal parenchyma, then migrated into the collecting system over a two-month period causing acute renal colic and necessitating removal by pyelotomy. A review of the literature discloses only 8 cases of projectiles migrating in the urinary tract, 5 involving metallic fragments and 3 involving bullets.