Retained Bullet in the Kidney: Imaging and Conservative Management

Renal gunshot wounds resulting in a grade IV injury (AAST) should be explored only if they involve the hilum or if there are signs of suspected renal pelvis or ureteral laceration, active hemorrhage, peritonitis, or hemodynamically unstable patients (Kitrey et al, 2017).¹ However, because of the paucity of cases reported in the literature, it is not clear what the best management of patients with a retained bullet is, which have been traditionally treated with surgical retrieval in other organs. We present the radiological findings and a clinical case summary of a patient with grade IV kidney injury and retained bullet managed conservatively.