Abstract
Background
Patients presenting with a penetrating missile lodged in the pelvis are at risk for
having a urinary tract injury. Once in the bladder, the missile can become impacted
in the urethra, causing retention that requires extraction. Rarely, the missile can
be expulsed spontaneously through the urethra.
Objectives
To describe the world literature regarding undetected penetrating bladder injuries
presenting as spontaneously voided bullets and to contribute an additional case to
the literature.
Case Report
We present a case report of a 37-year-old man who sustained a gunshot wound to the
right buttock, with an undetected urinary system injury and subsequent spontaneous
voiding of a bullet.
Conclusion
There have been <10 cases reported in the literature of spontaneously expulsed bullets
from the urethra, all of which were undetected injuries on initial presentation. Physicians
should be aware of the potential for undetected urinary tract injuries in patients
with penetrating missiles to the pelvis and understand the appropriate evaluation
and management strategies for these injuries.
Keywords
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References
- Foreign bodies in the urinary tract.in: Urology. Volume 1. Saunders, Philadelphia1978: 843-862
- Spontaneous expulsion of intravesical bullet.Urology. 1975; 3: 387-389
- Spontaneous passage of bullet during voiding.Southern Medical Journal. 1978; 71: 83-84
- Spontaneous passage of shell fragments during voiding.Br J Urol. 1984; 56: 334
- Spontaneous voiding of a bullet after a gunshot wound to the bladder: case report.J Trauma. 1993; 35: 813-814
- Spontaneous expulsion of an intravesical bullet.J Am Osteopath Assoc. 1997; 97: 415-416
- Spontaneous passage of shotgun pellets during voiding.Br J Urol. 1998; 81: 498
- Spontaneous expulsion of a bullet via the urethra.Int J Urol. 2004; 11: 567-577
- Masked urinary bladder injury with a bullet expulsed spontaneously during voiding.Ulus Travma Acil Cerrahi Derg. 2011; 17: 455-457
- Late erosion of shell fragment into the bladder.J Urol. 1946; 55: 483-485
- Urethral obstruction due to the passage of a retained projectile into the genitourinary system.Am J Emerg Med. 2008; 26: e1-e2
- Acute urinary retention from urethral migration of a retained bullet.J Trauma. 2002; 53: 790-792
- Tests for leakage in the early diagnosis of the ruptured bladder.J Urol. 1940; 44: 264-273
- CT cystography with multiplanar reformation for suspected bladder rupture: experience in 234 cases.AJR Am J Roentgenol. 2006; 187: 1296-1302
Article info
Publication history
Published online: May 28, 2013
Accepted:
March 27,
2013
Received in revised form:
October 23,
2012
Received:
May 29,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
