A 59-year-old man went to a doctor in Sulaymaniyah, Iraq, with pain in his left flank. The cause turned out to be an old injury: a shrapnel fragment from 18 years earlier had become the core of a 24-millimeter kidney stone.
Surgeons broke up the stone, but the metal inside would not shatter under either pneumatic or laser lithotripsy, two standard stone-breaking tools. They finally removed it through an incision in his lower back. The case was published Aug. 31 in the Journal of Surgical Case Reports.
