Missed bullet: a case report

ABSTRACT

A 27-year old Iraqi male patient with no known chronic illnesses presented with pain in the lower abdomen associated with frequency of micturition and blood in the urine with bouts of fever of about six years' duration. He gave a history that when he was 10years old during the war in Basrah, Iraq 1991,while he was playing football in the street one of his friends pointed out a red stain on the side of his T-Shirt. Removal of the shirt showed a small bloody wound over the left side of his back. No surgery was done at that time and the wound was treated by cleaning and dressing. Physical examination was normal apart from suprapubic tenderness. Blood test normal. Urine analysis-red blood cell 6-8/H.P.F. KUB full size bullet in the pelvis. CT-Scan Intravesical metallic foreign body [bullet] with right lateral wall linear calcification likely related to the site of entrance. Operation was done under spinal anesthesia and the bullet extracted from the urinary bladder. The post-operative period was uneventful and the patient was discharged after two days in a good condition and the stitches removed after eight days