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Intraluminal migration of surgical sponge: gossypiboma

Kundan K Patil1, Shaifali K Patil, Kedar P Gorad

  • 1Department of Surgery, MGM, Medical College, Kamothe, Navi Mumbai, India.

Insights

Retained surgical sponges, or gossypiboma, can cause serious abdominal complications like abscesses or masses. This case highlights rare intraluminal migration following a caesarean section, emphasizing diagnostic and management approaches.

Area of Science:

  • Surgical complications
  • Gastrointestinal surgery
  • Medical imaging

Background:

  • Retained surgical sponges (gossypiboma) are a preventable surgical complication.
  • Manifestations include inflammatory (abscess) or fibrotic (mass) reactions.
  • Intraluminal migration of surgical sponges is a rare occurrence.

Observation:

  • A 23-year-old woman presented with intestinal obstruction post-caesarean section.
  • Radiography and CT scans confirmed the presence of a gossypiboma.
  • The patient underwent exploratory laparotomy for sponge removal.

Findings:

  • Gossypiboma can migrate into the gastrointestinal tract, causing obstruction.
  • Multimodality imaging is crucial for diagnosing migratory gossypiboma.
  • Surgical intervention is necessary for removal.

Implications:

  • Highlights the importance of surgical counts and instrument checks to prevent retained foreign objects.
  • Underscores the need for high clinical suspicion in patients with prior abdominal surgery presenting with obstructive symptoms.
  • Informs surgical practice regarding the diagnosis and management of rare gossypiboma migration.

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