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Progressive ossification due to retained surgical sponge after upper leg amputation: a case report
Irene C Kouwenberg1, Jan Paul M Frölke
1Department of Surgery, Radboud University Medical Center, Nijmegen 690, The Netherlands. ic.kouwenberg@gmail.com
Cases Journal
|February 27, 2010
Summary
A retained surgical sponge in an amputated leg caused a rare gossypiboma, leading to pain, gait issues, and bone changes. Surgical removal was necessary to address these complications.
Area of Science:
- Medical Case Study
- Surgical Complications
- Radiology
Background:
- Retained surgical foreign bodies, such as sponges, can cause gossypiboma (foreign body granuloma).
- Gossypiboma typically occurs in the abdominal cavity, with rare instances reported in limbs.
Purpose of the Study:
- To report a rare case of gossypiboma in an amputated limb.
- To highlight the diagnostic and management challenges of retained surgical sponges in unusual locations.
Main Methods:
- A 29-year-old male presented with leg pain and altered gait years after amputation.
- Imaging (Roentgenogram, MRI) revealed a retained surgical sponge with calcifications in the stump.
- Surgical excision of the gossypiboma containing the sponge remnants was performed.
Main Results:
- A large, calcified surgical sponge was successfully removed from the patient's amputated leg stump.
- The patient experienced complications including infectious issues requiring further surgery.
- Post-removal, the patient had phantom limb pain, prosthetic leg dysfunction, and radiographic evidence of calcification and osteolysis.
Conclusions:
- Retained surgical sponges in amputated limbs can result in fibroma, bone destruction, osteolysis, and calcification.
- Gossypiboma in this location can cause significant functional impairment, including gait disturbance and prosthetic complications.