Textiloma presenting as a lump in abdomen: A case report

Textiloma or Gossypiboma is a mass comprising of cotton matrix within the body left accidentally during a surgical procedure. It is estimated that retained surgical foreign bodies occur one in every 5,500-18,760 inpatient operations but the incidence may be as high as one out of every 1,000-1,500 abdominal cavity operations, and even more common during emergency surgeries. There have also been rare case reports of Transmural migration of retained surgical swab which is a rare phenomenon. But even rarer is the incidence of retention of swab inside the small intestine in the previous procedure.

A 29-year-old female coming with chief complaints of pain in abdomen since 1 year which was colicky in nature, present all over abdomen, non-radiating. The pain aggravated on eating food. Patient also noticed a lump in her abdomen since past 1 year. Abdomen was opened and the bowel was inspected. Enterotomy was performed and two swabs were removed from the intestine.

Prevention of this condition can be achieved by meticulous count of surgical materials in addition to thorough exploration of surgical site at the conclusion of operations and also by routine use of surgical textile materials impregnated with a radio opaque marker.

Although rare, a diagnosis of retention of swab or surgical instruments must be considered in cases of vague lumps in abdomen or in cases of intestinal obstruction, especially if the patient has had previous history of laparotomy.