Intraabdominal gossypiboma: Report of two cases

Area of Science:

• Medical Case Reports
• Surgical Complications
• Abdominal Imaging

Background:

• Gossypiboma, a rare complication of surgery, refers to a retained foreign body, typically a surgical sponge.
• These entities can lead to significant medico-legal implications and often present with vague symptoms years after the initial procedure.
• The presentation of gossypiboma can mimic intra-abdominal malignancies, posing diagnostic challenges.

Purpose of the Study:

• To present two distinct cases of gossypiboma that mimicked intra-abdominal malignancy.
• To highlight the diagnostic difficulties associated with preoperative identification of gossypiboma.
• To emphasize the importance of considering gossypiboma in the differential diagnosis of abdominal masses in patients with a surgical history.

Main Methods:

• Case presentation of two female patients with postoperative abdominal masses.
• Review of radiological findings (imaging) and clinical presentation.
• Confirmation of diagnosis through exploratory laparotomy and subsequent pathological examination.

Main Results:

• Case 1: A 28-year-old woman with a history of cholecystectomy presented with an epigastric mass suggestive of cystadenocarcinoma.
• Case 2: A 36-year-old woman with a history of cesarean sections presented with a left lower quadrant mass near the ovary.
• Both cases were definitively diagnosed as gossypiboma via laparotomy and pathology.

Conclusions:

• Gossypiboma diagnosis is challenging due to nonspecific symptoms and delayed presentation.
• A high index of suspicion is essential for considering gossypiboma in patients with prior surgery and abdominal masses.
• Early and accurate diagnosis through a combination of clinical suspicion and diagnostic procedures is vital to avoid misdiagnosis as malignancy.