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Dinsa LH, Workineh BB, Hunde CR. Gossypiboma with enterocutaneous fistula after cesarean section: a case report and review of the literature. J Med Case Rep 2024; 18:515. [PMID: 39438894 PMCID: PMC11515851 DOI: 10.1186/s13256-024-04783-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 08/08/2024] [Indexed: 10/25/2024] Open
Abstract
INTRODUCTION Although precautions taken for surgical procedures are strict and effective in most operative theaters, the incidence of retained foreign bodies following surgery has a reported rate of 0.01-0.001%, of which gossypibomas make up 80% of cases. CASE PRESENTATION A 42-year-old woman who was Oromo in ethnicity came to the hospital with symptoms of infection, including pus drainage from her lower abdominal incision, fever, chills, and weight loss. Tests indicated an intraabdominal mass consistent with a foreign body from a previous surgery. An exploratory laparotomy revealed a surgical pack causing intestinal perforations. The foreign body was removed, and the patient recovered well postoperatively. CONCLUSION Retained surgical items are serious problems of surgical operations that can result in morbidity and mortality. Therefore, it should be among the differential diagnoses of any abdominal pain in patients having a history of prior surgery.
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Affiliation(s)
- Leta Hinkosa Dinsa
- Department of Midwifery, Wolegga University, Nekemte, Oromia Regional State, Ethiopia.
| | - Betel Bogale Workineh
- Department of Midwifery, Wolegga University, Nekemte, Oromia Regional State, Ethiopia
| | - Chala Regassa Hunde
- Department of Surgery, Wolegga University, Nekemte, Oromia Regional State, Ethiopia
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Han Y, Yang W, Dai W, Ma Q, Yuan T, Yang Y, Lu Y, Zhang B, Zhang M. Case Report: Laparoscopy-assisted resection for intra-abdominal gossypiboma masquerading as a jejunal tumor (with video). Front Oncol 2023; 13:1326032. [PMID: 38090487 PMCID: PMC10715586 DOI: 10.3389/fonc.2023.1326032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 11/10/2023] [Indexed: 01/03/2025] Open
Abstract
INTRODUCTION Intra-abdominal gossypiboma, a cotton-based retained foreign body after an abdominal surgery, is associated with various clinical manifestations and complications. Its infrequent occurrence and unpredictability make its early diagnosis particularly challenging. We herein present an atypical case of intra-abdominal gossypiboma mistaken for a jejunal tumor. CASE PRESENTATION A 33-year-old female presented to the emergency room with an acute episode of progressive abdominal pain and distention, nausea, and vomiting for 20 hours. She had undergone an urgent cesarean section due to fetal tachycardia seven years prior. The initial diagnosis of small bowel obstruction (SBO) due to a jejunal tumor was established by computed tomography. Subsequent to successful medical management of the SBO, a laparoscopy-assisted resection of the mass and the adherent jejunal segment was conducted, culminating in a primary side-to-side jejunojejunostomy. Examination of the excised tissue revealed an approximately spherical fibrous mass, 6 × 6 × 5 cm in dimension, embedded in the jejunal wall, housing a 20 × 20-cm gauze. Postoperative recovery and routine follow-up ensued without complications. CONCLUSION In light of this case, the need for clinicians to maintain an elevated awareness and suspicion of gossypiboma should be accentuated when evaluating an intra-abdominal mass, especially in patients with a prior history of high-risk laparotomy. Laparoscopic surgery stands out as a technically proficient and minimally invasive strategy for diagnosing and treating intra-abdominal gossypiboma. Besides, it is imperative to emphasize the importance of meticulous surgical procedures and postoperative protocols to prevent such oversights, reaffirming the need for consistent intraoperative counts and checks of surgical items.
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Affiliation(s)
- Yihui Han
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wenming Yang
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Wenshu Dai
- Key Laboratory of Transplant Engineering and Immunology, National Health and Family Planning Commission (NHFPC), West China Hospital, Sichuan University, Chengdu, China
| | - Qin Ma
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Yuan
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yun Yang
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yanrong Lu
- Key Laboratory of Transplant Engineering and Immunology, National Health and Family Planning Commission (NHFPC), West China Hospital, Sichuan University, Chengdu, China
| | - Bo Zhang
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Mingming Zhang
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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Yoshida R, Yoshizako T, Sonoyama H, Ryoji H, Iwahashi T, Ishikawa N, Tajima Y, Kitagaki H. Gossypiboma penetrating into the small intestine similar to Meckel's diverticulum: a report and literature review. Radiol Case Rep 2020; 15:655-659. [PMID: 32280395 PMCID: PMC7136597 DOI: 10.1016/j.radcr.2020.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 12/05/2022] Open
Abstract
Foreign body granuloma due to retained surgical sponge (gossypiboma) with penetration into the small intestine is very rare. Cases of gossypiboma in the abdominal cavity have sometimes been reported, yet the correct incidence has not been determined, only estimated to occur in one of every 1,000 to 1,500 intra-abdominal operations. Acute abdomen may be observed in some cases, requiring treatment. We herein introduce the case of a 70-year-old woman with gossypiboma penetrating into the small intestine presented with anemia and hematochezia. She had a history of emergency laparotomy for ectopic pregnancy several decades ago. A dynamic contrast-enhanced computed tomography revealed a hypovascular mass containing air bubbles that continued to the small intestine approximately 50 mm in size in the right lower abdomen. In addition to describing the presentation and outcome of our patient, we review the image findings of gossypiboma.
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Affiliation(s)
- Rika Yoshida
- Faculty of Medicine, Department of Radiology, Shimane University
| | | | - Hiroki Sonoyama
- Faculty of Medicine, Department of Gastroenterology, Shimane University
| | - Hyakudomi Ryoji
- Faculty of Medicine, Department of Digestive and General Surgery, Shimane University
| | - Teruaki Iwahashi
- Faculty of Medicine, Department of Organ Pathology, Shimane University
| | | | - Yoshitsugu Tajima
- Faculty of Medicine, Department of Digestive and General Surgery, Shimane University
| | - Hajime Kitagaki
- Faculty of Medicine, Department of Radiology, Shimane University
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Ishii T, Matsumoto S, Miyatani H, Mashima H. A case of gossypiboma diagnosed with transanal double-balloon enteroscopy. Clin J Gastroenterol 2019; 12:254-257. [PMID: 30456723 PMCID: PMC6542775 DOI: 10.1007/s12328-018-0920-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 11/09/2018] [Indexed: 11/25/2022]
Abstract
Gossypiboma is an iatrogenic granuloma caused by retained surgical gauze. A 48-year-old woman with a history of cesarean section was incidentally found to have a pelvic mass on preoperative computed tomography examination for pectus excavatum. Abdominal enhanced computed tomography showed a 40-mm mass containing air in the pelvis. The mass was suspected to be continuous with the ileum. Transanal double-balloon enteroscopy showed a small fistula that was likely caused by penetration of the ileum dozens of centimeters from the ileocecal valve. A yellow-brown, movable, and fibrous body was found in the fistula. A part of the fibrous body was extracted with forceps. Pathological examination revealed that it was gauze. This is the first reported case of an asymptomatic gossypiboma penetrating the ileum that was diagnosed with double-balloon enteroscopy. Our results suggest that double-balloon enteroscopy is useful for early diagnosis of pelvic mass penetrating intestine, including gossypiboma.
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Affiliation(s)
- Takehiro Ishii
- Department of Gastroenterology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan.
| | - Satohiro Matsumoto
- Department of Gastroenterology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Hiroyuki Miyatani
- Department of Gastroenterology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
| | - Hirosato Mashima
- Department of Gastroenterology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan
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