[Gossypiboma - the retained surgical towel]

A 48-year-old woman with a history of five previous laparotomies had symptoms of nonspecific abdominal pain and recurrent postoperative paralytic ileus six months after her last operation. Because of her as yet undiagnosed abdominal pain admission to a psychosomatic hospital was suggested.

MRI was performed because of increasing abdominal pain. It revealed an intraabdominal large surgical towel retained in the abdomen (gossypiboma: gossypium [Latin]:cotton; boma [Swahili]: place of concealment).

The surgical towel, accidentally left behind at one of the previous intraabdominal operation) was removed through a previous appendectomy scar. An abscess was additionally found at the operation. Three days later, a second laparotomy became necessary because of multiple intraabdominal interenteric abscesses. A segmental resection had to be performed for a chronic small-bowel stricture. Postoperatively, a subcutaneous wound infection developed. The patient was discharged home on 12th postoperative day.

Retained surgical towel (gossypiboma) is a rare but well known complication of surgery. It presents a diagnostic problem if there are no symptoms for a long time. To make the correct diagnosis it is important to simply to consider the possibility of gossypiboma after a complicated or unsatisfactory postoperative course.