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Published on: March 5, 2018
Complete transmural migration of a retained surgical sponge: an atypical case in image mimicking intussusception: A
Yu Zhou1, Ping Chen, Tang Qiao
1Department of General Surgery, Suzhou Municipal Hospital (North Campus), Suzhou Department of Gastrointestinal Surgery, Clinical Medical College of Yangzhou University (the Northern Jiangsu People's Hospital), Yangzhou Medical Research Center, Clinical Medical College of Yangzhou University (the Northern Jiangsu People's Hospital), Yangzhou, Jiangsu Province, China.
Rationale:
Intraluminal migration of a retained surgical sponge causing intestinal obstruction and fistula is extremely rare occurrence.
Patient Concerns:
A case of a 35-year-old male, who complaining a diffuse abdominal pain beginning three days earlier. He also complained of occasional vomiting, nonspecific abdominal pain, and an unintentional 15 kg weight loss during the past 2 years. However, there were no clear findings in previous laboratory work. He had received an open appendectomy approximately 4 years earlier.
Diagnoses:
Retained surgical sponge.
Interventions:
A contrast-enhanced CT of the abdomen showed a clear invagination of the small intestine. However, intraoperatively, we could not find an intestinal segment with intussusception. After the adhesive intestine was detached, a jejunal-ileal cross-linked fistula was found. More surprisingly, a retained surgical sponge was found inside the ileal fistula when the cross-linked fistula was detached.
Outcomes:
The patient was discharged 7 days after surgery.
Lessons:
This is the first report showing an atypical image of a complete transmural migration of a retained surgical sponge mimicking intussusception.
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