Delayed ureteral obstruction following gunshot pellet migration.

Following his initial presentation, he required an exploratory laparotomy, gastric oversew, and transverse colon repair, but was still known to have multiple remaining intra-abdominal pellets (Figure 1). He had no previous urological history, but urinalysis on admission revealed microscopic hematuria. Renal function was normal, but his C-reactive protein was increased at 38 mg/L (normal value <10 mg/L). A non-contrast computed tomography revealed one pellet had migrated into the left ureter causing ureteral obstruction and hydronephrosis (Figure 1). Initial management involved decompression of an infected system with a percutaneous nephrostomy followed by an antegrade pyle-