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[Gossypiboma after abdominal surgery is a challenging clinical problem and a serious medicolegal issue]
Silvana Marques E Silva1, João Batista de Sousa
1Faculdade de Medicina da Universidade de Brasília, Brasília-DF, Brasil. silvismarques@yahoo.com.br
Introduction:
The term "gossypiboma" refers to a textile matrix surrounded by foreign body reaction. Gauze and surgical dressings are the most commonly retained materials after laparotomy.
Aim:
To evaluate the incidence of abdominal gossypiboma, its causes and the preventive measures to reduce the frequence and morbimortality.
Method:
Was conducted a literature review in Medline/Pubmed in english. The survey was about the last 10 years, selecting the headings: gossypiboma, textiloma, retained foreign body and abdominal surgery. Thirty articles were considered in this review.
Results:
The incidence of gossypiboma is underreported, mostly due to the legal implications of their detection but also because many patients remain asymptomatic. Occur in 1/1000 to 1/1500 of intra-abdominal operations. Clinical presentation is variable, and depends on the location of the foreign body and on the type of inflammatory reaction presented by the host. The recommended course of treatment is excision, which can be accomplished endoscopically, laparoscopically, or via the open route, and seeks to prevent the complications that lead to a high mortality rate. The most important approach is prevention. Preventive measures required include exploration of the abdominal cavity at the end of the procedure, use of textiles with radiopaque markers and a meticulous account of surgical materials.
Conclusion:
Gossypiboma is a former medical-legal problem, whose incidence is apparently increasing. Therefore needs to be revised to take preventive measures in the operating room.
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