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Intrathoracic gossypiboma causing intractable cough.
Parvaiz A Koul1, Showkat A Mufti, Umar Hafiz Khan
1Department of Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India. parvaizk@gmail.com
A retained surgical sponge, known as a gossypiboma, caused persistent coughing in a patient eight months after thoracic surgery. Surgical removal resolved the symptoms, highlighting the importance of considering retained surgical items in post-operative complications.
Area of Science:
- Medical Case Report
- Surgical Complications
- Respiratory Medicine
Background:
- Post-tubercular fibrosis and bronchiectasis can necessitate complex thoracic surgeries.
- Persistent respiratory symptoms following thoracic surgery warrant thorough investigation.
- Retained surgical items, though rare, are a known complication of surgical procedures.
Observation:
- A 45-year-old woman experienced a 5-month cough after pneumonectomy for post-tubercular lung disease.
- Computerized tomography (CT) revealed a sponge-like mass in the pneumonectomy cavity.
- Bronchoscopy identified a whitish mass obstructing the bronchial stump, composed of cotton fibers.
Findings:
- The mass was identified as a gossypiboma, a retained surgical gauze.
- Surgical excision of the gossypiboma was successfully performed.
- The patient's cough resolved completely after the surgical removal.
Implications:
- Gossypibomas should be considered in the differential diagnosis of persistent symptoms after thoracic surgery.
- This case underscores the critical need for meticulous surgical counts and checks to prevent retained surgical items.
- Early diagnosis and management of gossypibomas are essential for patient recovery and preventing long-term complications.