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Retained surgical sponge (gossypiboma) after intraabdominal or retroperitoneal surgery: 14 cases treated at a single
Sedat Yildirim1, Akin Tarim, Tarik Z Nursal
1Department of General Surgery, Başkent University Adana Hospital, Adana, Turkey. ysedat@hotmail.com
Background And Aims:
The objective of this study was to present the etiology, clinical presentation, diagnosis, and management for 14 cases of gossypiboma [retained surgical sponge (RSS)] treated at a single center and to emphasize the importance of this potential complication.
Methods:
Data for 14 cases of RSS treated between January 1999 and December 2004 were retrospectively assessed. The details of preoperative evaluation, demographic features, and operative findings were recorded. Use of, and findings from, abdominal x-ray, ultrasonography, computed tomography, magnetic resonance imaging, and upper-gastrointestinal endoscopy were also noted.
Results:
In all cases, the RSS was surgically removed. Thirteen of the 14 patients were symptomatic, and the most frequent finding was nonspecific abdominal pain and intestinal obstruction. Four patients required urgent surgery because the sponges were causing intestinal obstruction or intraabdominal sepsis. Based on history, physical examination findings, and diagnostic imaging, RSS was diagnosed preoperatively in five of the patients. Postoperative complications, including surgical site infection and evisceration, occurred in five cases.
Conclusion:
RSS can lead to significant medical and legal problems between the patient and the doctor. RSS may be incorrectly diagnosed preoperatively, which can lead to unnecessary invasive diagnostic procedures and operations. Strict measures must be taken to prevent this complication.
Insights
Retained surgical sponges (RSS), or gossypibomas, can cause serious complications like intestinal obstruction and sepsis. Early diagnosis and strict prevention measures are crucial to avoid medical and legal issues.
Area of Science:
- Medical Complications
- Surgical Safety
Background:
- Gossypiboma, a retained surgical sponge (RSS), is a rare but significant complication following surgical procedures.
- It can lead to severe patient morbidity and medico-legal consequences.
Purpose of the Study:
- To review the etiology, clinical presentation, diagnosis, and management of 14 gossypiboma cases.
- To highlight the importance of preventing retained surgical sponges.
Main Methods:
- Retrospective analysis of 14 RSS cases treated between January 1999 and December 2004.
- Inclusion of preoperative evaluation, demographic data, operative findings, and imaging results (X-ray, ultrasound, CT, MRI, endoscopy).
Main Results:
- All 14 gossypibomas were surgically removed.
- Thirteen patients presented with symptoms, most commonly abdominal pain and intestinal obstruction.
- Preoperative diagnosis was achieved in only five cases, with five patients experiencing postoperative complications.
Conclusions:
- Retained surgical sponges pose significant medical and legal risks.
- Inaccurate preoperative diagnosis can lead to further invasive procedures.
- Strict preventive measures are essential to avoid gossypiboma formation.