DOI: http://dx.doi.org/10.18203/2349-2902.isj20195142

Gossypiboma: case report and review of literature

Tulasi Ram, Divya Dahiya, Anil Naik

Abstract


Gossypiboma or retained surgical sponge is an entirely preventable surgical complication; it is associated with significant morbidity to patient and medico legal issues to the surgeon. Clinical presentation depends upon location of the foreign body and tissue reaction to the foreign body. Pre-operative diagnosis is the most difficult part and treatment of choice is surgery. A 30 year female presented with 16 months history of gradually increasing lump on left side of lower abdomen following a caeserian section. Ultrasonography was suggestive of infected mesenteric cyst and contrast enhanced computed tomography scan of abdomen was suggestive of either chronic abscess or gossypiboma. She was treated surgically; intra-operatively there was a 10×10 cm well circumscribed lesion in sigmoid mesentery which was adherent to sigmoid colon. It was a single surgical sponge with about 1000 ml of pus. Gossypiboma is an entirely avoidable surgical complication which is associated with significant morbidity and medico-legal implications. Meticulous counts with thorough exploration of site before closure can lessen the undue morbidity or mortality. Radio frequency identification verification by barcode scanner can reduce the error rate.


Keywords


Gossypiboma, Textiloma, Lump abdomen

Full Text:

PDF

References


Arora RK, Johal KS. Gossypiboma in thigh- a case report. J Orthop Case Rep. 2014;4:22-4.

Rajput A, Loud PA, Gibbs JF, Kraybill WG. Diagnostic challenges in patients with tumors: Gossypiboma (foreign body) manifesting 30 years after laparotomy. J Clin Oncol. 2003;21:3700-1.

Srivastava KN, Agarwal A. Gossypiboma posing as a diagnostic dilemma: a case report and review of the literature. Case Rep Surg. 2014;2014:713428.

Lata I, Kapoor D, Sahu S. Gossypiboma a rare cause of acute abdomen: a case report and review of literature. Int J Crit Illn Inj Sci. 2011;1:157-60.

Wan W, Le T, Riskin L, Macario A. Improving safety in the operating room: a systematic literature review of retained surgical sponges. Curr Opin Anaesthesiol. 2009;22:207-14.

Mathew RP, Thomas B, Basti RS, Suresh HB. Gossypibomas, a surgeon’s nightmare-patient demographics, risk factors, imaging and how we can prevent it. Br J Radiol. 2017;90:20160761.

Gawande AA, Studdert DM, Orav EJ, Brennan TA, Zinner MJ. Risk factors for retained instruments and sponges after surgery. N Engl J Med. 2003;348:229-35.

Manzella A, Filho PB, Albuquerque E, Farias F, Kaercher J. Imaging of gossypibomas: pictorial review. AJR Am J Roentgenol. 2009;193:S94-101.

Moslemi MK, Abedinzadeh M. Retained intraabdominal gossypiboma, five years after bilateral orchiopexy. Case Rep Med. 2010;2010:420357.

Kopka L, Fischer U, Gross AJ, Funke M, Oestmann JW, Grabbe E. CT of retained surgical sponges (textilomas): pitfalls in detection and evaluation. J Comput Assist Tomogr. 1996;20:919-23.

Bulus H, Sımşek G, Coskun A, Koyuncu A. Intraabdominal gossypiboma mimicking gastrointestinal stromal tumor: a case report. Turk J Gastroenterol. 2011;22:534-6.

Yamato M, Ido K, Izutsu M, Narimatsu Y, Hiramatsu K. CT and ultrasound findings of surgically retained sponges and towels. J Comput Assist Tomogr. 1987;11:1003-6.

Choi BI, Kim SH, Yu ES, Chung HS, Han MC, Kim CW. Retained surgical sponge: diagnosis with CT and sonography. AJR Am J Roentgenol. 1988;150:1047-50.

Shyung LR, Chang WH, Lin SC, Shih SC, Kao CR, Chou SY. Report of gossypiboma from the standpoint in medicine and law. World J Gastroenterol. 2005;11:1248-9.

Cheng TC, Chou ASB, Jeng CM, Chang PY, Lee CC. Computed tomography findings of gossypiboma. J Chin Med Assoc. 2007;70:565-9.

Macario A, Morris D, Morris S. Initial clinical evaluation of a handheld device for detecting retained surgical gauze sponges using radiofrequency identification technology. Arch Surg Chic Ill. 1960. 2006;141:659-62.