Vertebromedullary wound with ureteral fistula.

We report a case of associated vertebromedullary and ureteral lesions in a severely injured patient, a victim of a gunshot aggression in Africa. Urine extended from the ureteral fistula through the third lumbar vertebral body, blended with cerebrospinal fluid from the dural attrition, and flowed very slowly through the dorsal exit ballistic hole. This is to our knowledge the first such case described in the literature. Uro-computed tomography scan finally made the diagnosis of ureteral fistula after two neurosurgical procedures determined that initially presumed dural persistent fistula needed to be closed.