A retained renal bullet - A rare case scenario
Genitourinary trauma secondary to a gunshot wound is uncommon as it only occurs in about 10% of cases. Doctors present a case of a gentleman who suffered a gunshot wound to the kidney.

A 28-year-old man presented with irritative lower urinary tract symptoms (LUTs) for three months. The medical history was irrelevant. He is a known case of neurogenic bladder maintained on regular clean intermittent catheterization (CIC). He has a history of a gunshot to the back for few years that resulted in spinal injury.

CTUT showed retained bullet inside the right kidney that look like a hyperdense renal stone, Moreover, multiple vesical stones. The vesical stones were treated with cystolitholapaxy. Given that the patient is asymptomatic, conservative management for the retained right renal bullet is the feasible option.

Retained renal bullet post gunshot injury to the back is an unusual presentation. A characteristic star-like pattern produced by lead shots and not by “stone,” consisting of a plastic detonating cap will aid the urologist to differentiate retained renal bullet from renal stone. In such a scenario, an asymptomatic renal bullet look-alike renal stone doesn't necessitate treatment.

International Journal of Surgery Case Reports
Source: https://doi.org/10.1016/j.ijscr.2021.106180