Masked urinary bladder injury with a bullet expulsed spontaneously during voiding

We report a case with gunshot to the pelvis. The injury site was the soft tissue between the rectum and urinary bladder. Several days later, the bullet was expulsed spontaneously during voiding. In the literature, only a few case reports have described spontaneous expulsion of an intravesical bullet. A 19-year-old male was wounded on the left hip by gunshot. Radiographic examinations showed a bullet in the pelvis, which was localized in the soft tissue between the rectum and urinary bladder, with no accompanying visceral injury on abdominopelvic computerized tomography. Macroscopic hematuria was noticed after urethral catheterization. Rectosigmoidoscopy and retrograde cystoscopic examinations were both negative. The patient was monitored closely and treated conservatively with no surgical intervention. The urinary catheter was removed on the fifth postoperative day, and the bullet was expulsed spontaneously via the urethra during normal voiding three hours after catheter removal. Thereafter, a retrograde urethrography was performed, which showed no evidence of urinary tract or bladder injury.

Ateþli silah yaralanmasýyla oluþan gizli mesane yaralanmasý ve kurþunun spontan miksiyonla üretradan atýlmasý

Bu yazýda, ateþli silahla pelvis yaralanmasý olan hasta sunuldu. Yaralanma bölgesi mesane ve rektum arasýndaki yumuþak doku idi. Birkaç gün sonra kurþun spontan miksiyon esnasýnda üretra yolu ile atýldý. Literatürde kurþunun kendiliðinden olarak üretra yolu ile atýldýðý birkaç nadir olgu bildirilmiþtir. On dokuz yaþýnda erkek hastanýn sol kalçasýnda ateþli silah yaralanmasý mevcut idi. Hemodinamik olarak stabil olan hastaya yapýlan direkt grafi ve bilgisayarlý tomografide pelvis içinde, mesane ve rektum arasýndaki yumuþak dokuda, organ hasarý oluþturmayan kurþun tespit edildi. Üretral kateterizasyon sonucu makroskopik hematüri tespit edildi. Rektosigmoidoskopi ve retrograd sistoskopik deðerlendirmeler negatif idi. Cerrahi giriþim yapýlmaksýzýn, hasta konservatif takip edildi. Beþinci gün, üriner kateteri çýkarýldýktan üç saat sonra kurþun üretradan kendiliðinden miksiyon esnasýnda atýldý. Bunun üzerine retrograd üretrosistografi yapýldý, üriner trakt ve mesane hasarýna rastlanmadý.