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Celik H, Akin IB, Altay C, Bisgin T, Obuz F. Giant gossypiboma presenting as a pelvic mass. Radiol Case Rep 2021; 16:3308-3310. [PMID: 34484537 PMCID: PMC8403700 DOI: 10.1016/j.radcr.2021.07.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 07/25/2021] [Accepted: 07/26/2021] [Indexed: 10/26/2022] Open
Abstract
Gossypiboma is a foreign object, such as a mass of cotton matrix or a sponge, that is left behind in a body cavity during surgery. It is uncommon, mostly asymptomatic, and hard to diagnose. It may be incorrectly diagnosed preoperatively, which can lead to unnecessary invasive diagnostic procedures and operations. It should be included in the differential diagnosis of soft-tissue masses detected in patients with a history of a prior operation. We present a case of 36-year-old female who referred to emergency room with severe abdominal pain and distension. Imaging revealed a giant intra-abdominal mass resembling a soft tissue tumor, but revealed to be a giant gossypiboma caused by a sponge that was forgotten during previous ectopic pregnancy surgery. This case differs from others with the absence of findings supporting gossypiboma such as calcification or trapped gas bubbles and emphasizes the importance of this potentially life-threatening complication of surgery.
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Affiliation(s)
- Hakki Celik
- Department of Radiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Isil Basara Akin
- Department of Radiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Canan Altay
- Department of Radiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Tayfun Bisgin
- Department of General Surgery, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Funda Obuz
- Department of Radiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
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Saxena N, Kardam DK, Chauhan R, Chaudhary T. Gossypiboma - Successful retrieval through laparoscopy: A case report. Int J Surg Case Rep 2021; 84:106109. [PMID: 34139422 PMCID: PMC8219774 DOI: 10.1016/j.ijscr.2021.106109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction Numerous complications can occur after a surgery, but gossypiboma is undoubtedly the most unwanted and undesirable complication of a procedure for any surgeon with legal implications. Once suspected, the minimally invasive surgical approach should be considered for its management. Presentation of case An adult P1L1E1 female presented to the surgery OPD with a painless abdominal mass which progressively increased in size in the past 4 months. She underwent emergency surgery for a ruptured ectopic pregnancy 6 months back at some other health centre. On computed tomography scan of the abdomen, a well-defined heterogenous cystic lesion of size 9.8 cm × 9.2 cm × 7 cm was noted intraperitoneally. Few air foci with a hyperdense tubular structure within the lesion were seen, suggestive of a retained surgical sponge with its radio-opaque marker also visualised. The retained sponge was successfully retrieved by the laparoscopic approach. Discussion Traditionally, the open approach for the removal of the sponge was more accepted compared to the laparoscopic approach. This was due to the belief that intense foreign body reaction and dense adhesions around the sponge may make the laparoscopic approach difficult. However, laparoscopy can prove to be beneficial with its advantages of early ambulation, reduced post-op pain, cosmetically improved results and shorter length of hospital stay. Conclusion All precautions must be taken to avoid retention of surgical sponge post-surgery. Case reports in which laparoscopy is used to retrieve gossypiboma are rare. The authors recommend the use of laparoscopy as a therapeutic option in the event of such mishaps. Gossypiboma is undoubtedly one of the most unwanted and undesirable complication of a procedure for any surgeon with legal implications. We present a case of an adult female who presented with a painless abdominal mass. Imaging was done and a diagnosis of gossypiboma was made. The gossypiboma was successfully retrieved by the laparoscopic approach. Case reports in which laparoscopy is used to retrieve gossypiboma are rare. Once suspected, the minimally invasive surgical approach should be considered for the management of gossypiboma.
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Affiliation(s)
- Neeraj Saxena
- Department of General & Minimally Invasive Surgery, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Dinesh Kumar Kardam
- Department of General & Minimally Invasive Surgery, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Rohit Chauhan
- Department of General & Minimally Invasive Surgery, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, India.
| | - Tayod Chaudhary
- Department of General & Minimally Invasive Surgery, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, India
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Kabba MS, Forde MY, Beckley KS, Johnny B, Jah-Kabba AMBM, Seisay SB, Dawoh AM, Ogundiran T. Gossypiboma with perforation of the umbilicus mimicking a complicated urachal cyst: a case report. BMC Surg 2020; 20:242. [PMID: 33069217 PMCID: PMC7568021 DOI: 10.1186/s12893-020-00904-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 10/08/2020] [Indexed: 11/10/2022] Open
Abstract
Background A retained surgical sponge, also known as a gossypiboma, is a rare cause of serious postoperative complications. Diverse retained surgical materials including instruments such as clamps and sutures have been reported, but surgical sponges are the most common material. We report an unusual case of a gossypiboma mimicking a complicated urachal cyst that led to perforation of the umbilicus. Case presentation A 38-year-old female patient presented in our facility with a palpable periumbilical mass and discharge of pus from the umbilicus for 7 months after an open appendectomy. Since the onset of symptoms, the patient had been treated conservatively in a peripheral hospital where she had been operated on. As no improvement was seen, an ultrasound scan was performed that suggested an intraperitoneal abscess adjacent to the umbilicus. Consequently, the patient was referred to our specialist outpatient department for surgical intervention. Suspecting a complicated urachal cyst, an exploratory laparotomy was performed but revealed a retained surgical sponge as the underlying cause. The gossypiboma was resected, and the postoperative period was unremarkable. Conclusion This case demonstrates that gossypibomas, even though rare, continue to occur. They may clinically and radiologically mimic other pathologies, especially abscesses and tumors. Preventive measures as well as the inclusion of gossypibomas in the differential diagnosis of intraabdominal masses or fistulation detected in patients with a history of surgery are of utmost importance to minimize morbidity, mortality, and potential medicolegal implications.
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Affiliation(s)
- Mustapha S Kabba
- Department of Surgery, College of Medicine and Allied Health Sciences, University of Sierra Leone and Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone.
| | - Martha Y Forde
- Department of Surgery, College of Medicine and Allied Health Sciences, University of Sierra Leone and Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone
| | - Kevin S Beckley
- Department of Surgery, College of Medicine and Allied Health Sciences, University of Sierra Leone and Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone
| | - Bernadette Johnny
- Department of Surgery, College of Medicine and Allied Health Sciences, University of Sierra Leone and Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone
| | - Ann-Marie B M Jah-Kabba
- Department of Radiology, Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone
| | - Samuel B Seisay
- Department of Surgery, College of Medicine and Allied Health Sciences, University of Sierra Leone and Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone
| | - Alusine M Dawoh
- Department of Surgery, College of Medicine and Allied Health Sciences, University of Sierra Leone and Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone
| | - Temidayo Ogundiran
- Department of Surgery, College of Medicine and Allied Health Sciences, University of Sierra Leone and Connaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone.,College of Medicine, University of Ibadan & University College Hospital, Ibadan, Nigeria
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Sankpal J, Tayade M, Rathore J, Parikh A, Gadekar D, S SF, Sankpal S. Oh, My Gauze !!!- A rare case report of laparoscopic removal of an incidentally discovered gossypiboma during laparoscopic cholecystectomy. Int J Surg Case Rep 2020; 72:643-646. [PMID: 32513591 PMCID: PMC7365772 DOI: 10.1016/j.ijscr.2020.04.058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/04/2020] [Accepted: 04/20/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION The work has been reported in line with the SCARE criteria. The most common retained foreign body during surgery is woven cotton surgical sponge, which includes both laparotomy pads and smaller sponges. Sponges are easily retained because of their ubiquitous use, relatively small size and when soaked in blood, sponges conform to and can be difficult to distinguish from surrounding tissues. The problem of retained surgical sponge is known as gossypiboma, and also as 'textiloma', 'gauzoma' or 'muslinoma'. The number of preoperatively diagnosed cases treated by laparoscopic approach is rare in the literature and laparoscopic removal of incidentally detected gossypiboma with concomitant laparoscopic cholecystectomy is not yet reported in the literature. PRESENTATION OF CASE In 40-year-old female with caesarean section 5 years ago, now during elective laparoscopic cholecystectomy and umbilical hernia repair, an incidentally detected Gossypiboma was encountered. The Gossypiboma was safely excised by laparoscopic technique followed by laparoscopic cholecystectomy and open hernia repair. DISCUSSION Postoperative complications following surgery are common and mostly unavoidable but some like the gossypiboma are infrequent and avoidable. Most of them are asymptomatic and present in the body for a long period of time. However, once discovered these foreign bodies must be removed for which laparoscopy proves to be a better approach. Most of these cases also are under-reported due to medicolegal implications. CONCLUSION Gossypiboma is one of the preventable complications of surgery by the compliance of certain measures perioperatively. If detected incidentally, it can be safely managed laparoscopically with a shorter post-operative hospital stay and better cosmetic results.
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Affiliation(s)
- Jitendra Sankpal
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India.
| | - Mukund Tayade
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
| | - Jai Rathore
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
| | - Atish Parikh
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
| | - Deepak Gadekar
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
| | - Shaba Fathima S
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
| | - Sushrut Sankpal
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Carvalho FSR, Costa FWG, Chaves FN, Scarparo HC, Soares ECS. Maxillofacial Gossypiboma: Case Report, Review of the Literature, and Diagnosis Algorithm. J Maxillofac Oral Surg 2020; 19:50-53. [PMID: 31988564 DOI: 10.1007/s12663-019-01242-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 05/18/2019] [Indexed: 11/25/2022] Open
Abstract
Gossypiboma is a retained surgical sponge and represents a rare complication with an uncertain incidence probably due to medical-legal implications. It is an iatrogenic condition solely due to human factors. While the medical literature has previously described cases of this entity after orthopedic, abdominal, otorhinolaryngology, and plastic surgery procedures, gossypibomas in oral and maxillofacial region are uncommon. It can mimic neoplasms or other injuries, which may promote a delayed diagnosis; thus, the differential diagnosis should be based on clinical history in each particular case. Although there are no pathognomonic features of gossypiboma in oral and maxillofacial region, the most common symptoms suggestive of persistent inflammation include pain, fever, swelling, surgical wounds that do not heal, and purulent drainage. The aim of this study was to report a maxillofacial gossypiboma misdiagnosed as third molar surgery-related odontogenic infection and a diagnosis algorithm.
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Affiliation(s)
- Francisco Samuel Rodrigues Carvalho
- 1Division of Oral and Maxillofacial Surgery, University of Fortaleza - UNIFOR, Fortaleza, Brazil
- 2Post-graduate Program in Dentistry, Federal University of Ceará, Fortaleza, CE Brazil
| | - Fábio Wildson Gurgel Costa
- 3Division of Oral Radiology, Department of Clinical Dentistry, Federal University of Ceará, Fortaleza, CE Brazil
| | - Filipe Nobre Chaves
- 4Department of Clinical Dentistry, Federal University of Ceará Campus Sobral, Sobral, CE Brazil
| | - Henrique Clasen Scarparo
- 5Division of Clinical Pharmacology, Department of Clinical Dentistry, Federal University of Ceará, Fortaleza, CE Brazil
| | - Eduardo Costa Studart Soares
- 6Division of Oral and Maxillofacial Surgery, Walter Cantídio University Hospital, Federal University of Ceará, Fortaleza, CE Brazil
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Mansoor A, Shaukat R, Saeed H, Chaudhary AN, Saeed H. Migratory Gossypiboma: An Unusual Presentation Of A Rare Surgical Complication. J Ayub Med Coll Abbottabad 2018; 30:617-619. [PMID: 30632351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Gossypiboma is a rare surgical complication associated with significant patient morbidity and even mortality. Migratory gossypiboma is a rarer subset of these cases, representing the erosion of surgical sponge into the intestine with consequent complications. A 40 years old female presented with a surgical sponge that had eroded into the caecum and subsequently moved with peristalsis up to the anal canal from which it was protruding out at the time of presentation. Proper checking before surgical closure can prevent this serious potentially lifethreatening complication.
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Affiliation(s)
- Ali Mansoor
- Department of Radiology, Shalamar Hospital, Lahore, Pakistan
| | - Rabia Shaukat
- Department of Radiology, Shalamar Hospital, Lahore, Pakistan
| | - Haroon Saeed
- Department of Radiology, Jinnah Hospital, Lahore, Pakistan
| | | | - Haroon Saeed
- Department of Radiology, Jinnah Hospital, Lahore, Pakistan
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Patial T, Rathore N, Thakur A, Thakur D, Sharma K. Transmigration of a retained surgical sponge: a case report. Patient Saf Surg 2018; 12:21. [PMID: 30127854 PMCID: PMC6087538 DOI: 10.1186/s13037-018-0168-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 07/27/2018] [Indexed: 01/04/2023] Open
Abstract
Background A retained surgical sponge remains a dreaded complication of modern surgery. Despite the increasing focus on patient safety instances of “a sponge being left in the abdomen”, are all too common in popular media. In this article we report the rare phenomenon of transmigration of a retained surgical sponge in a patient who underwent laparoscopic sterilization. Case presentation A 30-year-old female presented with progressive abdominal pain for about one month and vomiting with obstipation for 2 days. The patient had undergone laparoscopic sterilization 7 years back and then underwent re-canalization one year back. She underwent an exploratory laparotomy for suspected adhesive small bowel obstruction. During surgery, an intra-luminal surgical sponge was recovered from the distal small bowel. The patient recovered and was discharged in good health. Conclusion Despite numerous advances in terms of technology and the ever-growing emphasis on patient safety, the problem of a retained surgical sponge remains a dreaded potential complication. All clinicians and health care professionals should be aware of this entity and its various presentations.
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Affiliation(s)
- Tushar Patial
- The Clinic, Sanjauli, Shimla, Himachal Pradesh 171006 India
| | - Namit Rathore
- 2Department of General Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh India
| | - Angesh Thakur
- 3Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Digvijay Thakur
- 2Department of General Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh India
| | - Kanika Sharma
- Department of Radiation Therapy, Rajiv Gandhi Cancer Hospital and Research Centre, New Delhi, India
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Turgut M, Akhaddar A, Turgut AT. Retention of Nonabsorbable Hemostatic Materials ( Retained Surgical Sponge, Gossypiboma, Textiloma, Gauzoma, Muslinoma) After Spinal Surgery: A Systematic Review of Cases Reported During the Last Half-Century. World Neurosurg 2018; 116:255-267. [PMID: 29807184 DOI: 10.1016/j.wneu.2018.05.119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/15/2018] [Accepted: 05/16/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Retention of nonabsorbable hemostatic materials (RNHMs), that is, retained surgical sponge, gauzoma, gossypiboma, muslinoma, or textiloma, is a rarely seen surgical complication after spinal surgery that may remain asymptomatic for many years and may represent a diagnostic difficulty with associated medicolegal implications. METHODS We performed a systematic review of the English-language literature published between 1965 and 2017, accessed through 4 popular databases. We found a total of 37 articles (24 case reports; 7 image presentations; 5 clinical series, and 1 letter to editor) containing 58 cases of RNHMs located within the spinal canal or around the spinal column after surgery. RESULTS In this study, there were 29 female and 29 male patients from 13 countries, ages ranging from 17 years to 87 years, with initial diagnoses of lumbar or cervical disc herniation, spinal stenosis, or spondylolisthesis (n = 54), or spinal tumor (n = 4). The interval from the initial surgery to the presentation of RNHMs ranged from 13 days to 40 years, with a mean of 75.9 months. Various imaging techniques such as computed tomography and magnetic resonance imaging were used with histologic study, confirming the presence of RNHMs in the majority of patients with a complete recovery resulting in 93% of patients. CONCLUSIONS RNHMs is an overreported entity in underdeveloped or developing countries, including Turkey and Morocco, with progression occurring over years. RNHMs should be considered in the differential diagnosis of any patient who presents with back pain, spinal cord, or nerve roots symptomatology after spinal surgery.
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Affiliation(s)
- Mehmet Turgut
- Department of Neurosurgery, Adnan Menderes University School of Medicine, Aydın, Turkey.
| | - Ali Akhaddar
- Department of Neurosurgery, Avicenne Military Hospital of Marrakech, Mohammed V. University in Rabat, Rabat, Morocco
| | - Ahmet T Turgut
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
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Sozutek A, Colak T, Reyhan E, Turkmenoglu O, Akpınar E. Intra-abdominal Gossypiboma Revisited: Various Clinical Presentations and Treatments of this Potential Complication. Indian J Surg 2015; 77:1295-300. [PMID: 27011554 DOI: 10.1007/s12262-015-1280-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 05/11/2015] [Indexed: 10/23/2022] Open
Abstract
Gossypiboma is the term used to describe a retained non-absorbable surgical material that is composed of cotton matrix which leads to serious surgical complications for both patient and surgeon. Its incidence is not precisely known probably due to medico-legal importance of this potential complication. The condition may manifest either as asymptomatic or severe gastrointestinal complications. The increasing number of recent reports in the literature implies that this issue still remains as an important problem to be solved after intra-abdominal surgery. In this report, we aimed to emphasize this potential complication by presenting the clinical outcomes of our 14 patients who underwent different surgical interventions for gossypiboma. Between February 2009 and October 2014, a total of 14 patients who underwent surgery for gossypiboma were reviewed retrospectively. The patients were analyzed with regard to demographic characteristics, initial diagnosis-prior surgery, clinical presentation, the interval period from the first operation to last definite operation, diagnostic methods, gossypiboma location, definite surgery, and postoperative outcomes. A total of 14 patients including 6 (42.9 %) male and 8 (57.1 %) female with a median age of 41.4 ± 12 years (22-61 years) enrolled in this study. The prior surgery of 10 (71.4 %) patients was performed by general surgeons, while 4 (28.6 %) patients were operated by gynecologists. The interval period from prior surgery to definite surgery ranged from 14 days to 113 months. Three (21.4 %) patients were asymptomatic, whereas the vast of the patients were complicated (fistula, ileus, wound infection). Gossypiboma was removed by open surgery, laparoscopic surgery, and endoscopic intervention in 10, 2, and 1 patient, respectively. Removal was performed from perineal wound side in one patient. Removal was enough for definitive treatment in 10 (71.4 %) patients whereas bowel resection and primary repair was performed in 4 (28.6 %) patients due to fistula or perforation. One patient died from intra-abdominal sepsis on postoperative 13th day. Gossypiboma should strongly be considered in differential diagnosis of any postoperative patient with mild gastrointestinal symptom or with persistent wound infection. Adequate surgical intervention should be planned as soon as possible either to prevent further complications or to overcome medico-legal problems, when gossypiboma is detected.
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Affiliation(s)
- Alper Sozutek
- Department of Gastroenterological Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Tahsin Colak
- Department of General Surgery, Mersin University Medical Faculty, Mersin, Turkey
| | - Enver Reyhan
- Department of Gastroenterological Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Ozgur Turkmenoglu
- Department of General Surgery, Mersin University Medical Faculty, Mersin, Turkey
| | - Edip Akpınar
- Department of Gastroenterological Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
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12
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Khan YA, Asif M, Al-Fadhli W. Intraluminal gossypiboma. APSP J Case Rep 2014; 5:17. [PMID: 25057470 PMCID: PMC4090815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 04/12/2014] [Indexed: 11/07/2022] Open
Abstract
Gossypiboma (GP) or retained surgical sponge is one of the rare surgical complications which can happen despite precautions. Because of the medico-legal issues, it is under-reported. An 8-year-old thalassemic girl, with a history of splenectomy and cholecystectomy, presented to us with acute intestinal obstruction and required surgical exploration. Intraluminal gossypiboma obstructing the ileum was found. Though a rare cause, gossypiboma should also be included in the differential diagnoses of postoperative intestinal obstruction.
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Kato T, Yamaguchi K, Kinoshita K, Sasaki K, Kagaya H, Meguro T, Morita T, Takahashi T, Tamaki N, Horita S. Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine. Case Rep Gastroenterol 2012; 6:754-9. [PMID: 23341797 PMCID: PMC3551410 DOI: 10.1159/000346285] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A 56-year-old woman with a history of gynecological surgery for cervical cancer 18 years previously was referred to our hospital for colicky abdominal pain, nausea and vomiting. Intestinal obstruction was diagnosed by contrast-enhanced computed tomography (CT) which showed dilation of the small intestine and suggested obstruction in the terminal ileum. In addition, CT showed a thick-walled cavitary lesion communicating with the proximal jejunum. 18F-fluorodeoxyglucose positron emission tomography showed abnormal uptake at the same location as the cavitary lesion revealed by CT. The patient underwent laparotomy for the ileus and resection of the cavitary lesion. At laparotomy, we found a retained surgical sponge in the ileum 60 cm from the ileocecal valve. The cavitary tumor had two fistulae communicating with the proximal jejunum. The tumor was resected en bloc together with the transverse colon, part of the jejunum and the duodenum. Microscopic examination revealed fibrous encapsulation and foreign body giant cell reaction. Since a retained surgical sponge without radiopaque markers is extremely difficult to diagnose, retained surgical sponge should be considered in the differential diagnosis of intestinal obstruction in patients who have undergone previous abdominal surgery.
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Affiliation(s)
- Takashi Kato
- Department of Internal Medicine, Hokkaido Gastroenterology Hospital, Sapporo, Japan
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Abstract
Gossypiboma is the technical term for a retained surgical sponge. Because of legal-ethical concerns, there have not been many publications on this topic. Delays in diagnosis and treatment might increase mortality and morbidity. Radiological imaging is used in diagnosis. We present a case of gossypiboma that had fistulized to bulbous following hydatic cyst surgery. We established the diagnosis with endoscopy and followed its migration endoscopically.
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