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Beware of gossypibomas
Takahiro Karasaki1, Yukihiro Nomura, Tassei Nakagawa
1Department of Surgery, Asahi General Hospital, Asahi, Japan. tak.karasaki@gmail.com
BMJ Case Reports
|July 2, 2013
Summary
Gossypiboma, a retained surgical sponge, is a rare complication after surgery. Early consideration in patients with unexplained symptoms and prior surgery is crucial for diagnosis and management.
Area of Science:
- Medical Case Study
- Surgical Complications
- Diagnostic Imaging
Background:
- Gossypiboma, a retained surgical sponge, is a rare but significant surgical complication.
- Despite preventative measures, foreign body retention can occur postoperatively.
- Prompt diagnosis and management are essential to prevent morbidity.
Observation:
- A 33-year-old woman presented with persistent epigastric pain post-endoscopic retrograde cholangiopancreatography for choledocholithiasis.
- She had a history of an emergency cesarean section 6 weeks prior.
- Contrast-enhanced CT revealed an encapsulated mass with a spongiform pattern, suggesting gossypiboma.
Findings:
- A retained surgical sponge (gossypiboma) was surgically removed.
- The gossypiboma lacked radiopaque markers, complicating initial detection.
- Postoperative wound infection occurred, but the patient's overall recovery was otherwise uneventful.
Implications:
- Gossypiboma should be included in the differential diagnosis for patients with indeterminate abdominal pain, infection, or masses, especially with a surgical history.
- The case highlights the importance of vigilance for retained surgical items, even without radiopaque markers.
- Awareness of gossypiboma can lead to earlier diagnosis and improved patient outcomes.
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