Gossypiboma and its implications

Surgical materials are sometimes inadvertently left in the body after surgical operations. Cotton materials are the commonest objects forgotten. The implications for the patient and the surgeon are grave. The purpose of this presentation is to rekindle awareness of the phenomenon of gossypiboma, highlight the implications and stress prevention. Data were collected from hospital records which included their demographics, clinical features, management outcome and follow-up. Four cases of gossypiboma were found. Two had undergone caesarian section, one underwent pelvic floor repair for utero-vaginal prolapsed, and the fourth underwent transvesical prostatectomy. Their age, sex, causative operation and onset of symptoms, and salvage procedures were noted. Out of the 12304 surgical cases managed in our facility between November 1997 and December 2012, 4 (0.03%) cases of gossypiboma were recorded. Gauze extruded spontaneously from the abdominal scar in one patient who had undergone caesarian section. Intestinal obstruction occurred in another case of caesarian section and was relieved by intestinal resection and anastomosis. Also gauze extruded and was extracted from the urethra in the patient who underwent transvesical prostatectomy. Three (75%) patients survived while one (25%) died. We conclude that gossypiboma occurs most commonly after intra-abdominal operations. Women are at increased risk during obstetric and gynaecological operations, though both sexes are affected. The condition carries potentials for harm to the patient and medico-legal litigations.