Ureteral Injury by a Retained Knife After Abdominal Trauma: A Case Report

Abstract

Isolated ureteral injuries are rare, occurring particularly in gunshot wounds to the abdomen. These are much rarer in the context of stab wounds. These lesions are usually silent. We report a 30-year-old man with a history of abdominal penetrating trauma with a knife, 11 years ago before the actual admission to the urology department. The patient's report describes a retained metallic foreign body in the right lumbar area. At admission, the patient presented with a four-months history of right lumbago. An abdominal computed tomography scan revealed the presence of a right para-renal small urinoma and identified the 52 x 20 mm metallic foreign body at the level of L3 and L4 vertebral bodies, with the presence of mild right ureterohydronephrosis. Ureteral injuries can lead to significant morbidity and mortality when unrecognized or mismanaged. The basis of therapy for patients with ureteral injuries is to maintain renal drainage with options depending on individual cases.

Keywords: foreign body; genitourinary trauma; stab wound; ureter; ureteral injury.

Figure 1. Abdominal radiograph

The image reveals the presence of a 50 x 20 mm metallic foreign body (red arrow) at the right lumbar area at the level of L3 and L4 vertebral bodies.

Figure 2. Abdominal computed tomography scan

The image reveals the presence of a 52 x 20 mm metallic foreign body in the lumbar region at the level of L3 and L4 vertebral bodies. Exploration of the left kidney and ureteral duct revealed no anomalies.