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Transmural migration of a retained laparotomy sponge
Jasbir S Dhillon1, Adrian Park
1Department of Surgery, University of Kentucky, Lexington 40536-0293, USA.
The American Surgeon
|July 23, 2002
Summary
A retained surgical sponge caused a patient severe abdominal pain 11 months after a hysterectomy. This case highlights the critical need for meticulous surgical site exploration to prevent retained foreign body complications.
Area of Science:
- Surgical safety and patient outcomes
- Medical device-related complications
Background:
- Retained surgical foreign bodies, particularly laparotomy sponges, are a recognized complication in healthcare.
- Clinical presentations range from asymptomatic findings to severe inflammatory responses, including obstruction and perforation.
Observation:
- A patient presented with abdominal pain 11 months post-hysterectomy, with retained surgical sponge identified as the cause.
- Despite documented sponge counts, one laparotomy sponge was overlooked during the initial surgery.
Findings:
- An inflammatory response formed an abscess pocket around the retained sponge, leading to ileal perforation.
- The sponge migrated into the small bowel lumen via the perforation and was subsequently removed surgically.
Implications:
- This case underscores the critical importance of comprehensive abdominal exploration at the conclusion of surgical procedures.
- Emphasizes the need for vigilance in surgical counts and postoperative monitoring to prevent retained surgical items.