Case Report: Laparoscopy-assisted resection for intra-abdominal gossypiboma masquerading as a jejunal tumor (with video)

The Enigma of Gossypiboma: An Entity to Explore

Gossypibomas, or retained surgical sponges, are rare and potentially life-threatening complications in modern medicine. They are most commonly the result of emergency abdominal or gynecological surgeries but can occur in any surgery where sponges are used intraoperatively. They can remain in the body for years following surgery and pose a risk for migration and subsequent complications. This case describes an abdominal gossypiboma in a 90-year-old woman, first identified more than a decade after a salpingo-oophorectomy. Migration into her colon eventually caused bowel obstruction and resulted in death. Intentional underreporting of gossypibomas is a major problem that limits knowledge of the condition and hinders their prevention.

Jejunal Gossypiboma Mimicking a Gastrointestinal Stromal Tumor: A Case of a Rare Iatrogenic Complication and Review of the Literature

The term "gossypiboma" or "textiloma" is used to describe a mass of retained cotton matrix and the surrounding inflammatory response inside a body cavity following surgical intervention. The precise incidence of this phenomenon is uncertain, as cases are frequently underreported due to concerns related to medical malpractice. This rare complication poses a diagnostic dilemma due to the non-specific clinical and radiological features, which can result in significant morbidity and mortality. While diagnosis of this condition has been reported through various imaging modalities such as abdominal ultrasound and computed tomography, there are instances where cases do not present with typical findings, which can make it tough to make a preoperative diagnosis. The differential diagnosis from submucosal tumors of the gastrointestinal tract becomes challenging, particularly when the tumors are in contact with the gastrointestinal tract. It is possible that patients may be incorrectly informed that masses may be malignant, which could result in unnecessary extirpative surgery. In some cases, the diagnosis is discovered postoperatively. This case report presents a case of a 42-year-old woman who was initially suspected of having a gastrointestinal stromal tumor based on radiological findings. However, the patient was ultimately diagnosed with a gossypiboma following surgical intervention. A gross examination of the surgical specimen revealed that a gauze left over from a cesarean section performed nearly 20 years ago was the source of the gossypiboma. It is therefore evident that meticulous counting of surgical instruments and materials is crucial for patient safety and optimal outcomes.

Gossypiboma with enterocutaneous fistula after cesarean section: a case report and review of the literature

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.