Successful management of penetrating shrapnel injury to the left ureter with delayed projectile migration through the urinary tract

Abstract

IntroductionWe present a case of successful endoscopic treatment of a penetrating shrapnel injury to the left ureter. The patient experienced spontaneous migration of the projectile through the urinary tract, leading to renal colic.Case presentationA military man sustained multiple shrapnel injuries to the soft tissues and abdomen, including lacerations of the intestines, during enemy shelling in eastern Ukraine. On the 35th day after the trauma, the patient reported sudden pain in the left lumbar area. Subsequent investigation confirmed the presence of a foreign body in the lower part of the left ureter, accompanied by contrast extravasation. Ureteroscopy revealed a round‐shaped metal shrapnel, which was removed. A double‐J stent was inserted into the left ureter.ConclusionThe endoscopic extraction of the shrapnel fragment and the subsequent placement of a ureteral stent for the repair of the ureteral injury have proven to be safe and effective methods.