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Intrathoracic Gossypiboma: An Overlooked Entity
Sharifah A Othman1, Jihad Q AlSafwani1, Abdullah AlSahwan1
1Thoracic Surgery Division, Department of Surgery, King Fahad Hospital of The University, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
The American Journal of Case Reports
|September 7, 2020
Summary
Gossypiboma, or retained surgical sponges, can cause severe complications and mortality. Proper sponge counts and radiopaque markers are crucial for preventing retained surgical items.
Area of Science:
- Medical Science
- Surgical Safety
- Patient Outcomes
Background:
- Retained surgical sponges (gossypiboma) are a preventable cause of surgical morbidity and mortality.
- This clinical oversight leads to serious postoperative complications, increased mortality risk, and significant healthcare costs due to reoperations.
- Delayed diagnosis of gossypiboma can range from acute symptoms to asymptomatic presence for years.
Observation:
- A case report details a 48-year-old male who developed an intrathoracic gossypiboma after thoracotomy.
- The gossypiboma was initially misidentified radiologically as a surgical staple line.
- Nurses identified the retained sponge during post-surgical counts due to its differing appearance.
Findings:
- Adherence to surgical safety checklists and accurate sponge counts are vital for preventing retained surgical items.
- Gossypiboma diagnosis is frequently delayed or missed, necessitating additional interventions.
- Radiopaque markers in surgical materials and intraoperative radiology can aid early detection.
Implications:
- Implementing strict surgical counting protocols can significantly reduce the incidence of gossypiboma.
- The use of radiopaque markers in sponges is recommended to improve detection rates.
- Intraoperative radiology before skin closure is a valuable tool for preventing retained surgical objects and subsequent patient harm.
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