Abdominal textiloma mimicking as gastrointestinal stromal tumor: A case report

Gossypiboma or textiloma is a mass comprising of cotton matrix within the body left accidentally during a surgical procedure. The body may react to this foreign body through an exudative inflammatory reaction or an aseptic fibrotic reaction in order to encapsulate the cotton material and result into a mass.

We report a case of 65-year-old female. She was referred to our department due to 2 episodes of nausea and vomiting. She had history of open cholecystetomy 29 years ago, then cure for eventration one year after. On exploratory laparotomy there was a mass measuring 6 cm axis at the expense of segment 3 of the liver coming into intimate contact with the duodenum. Atypical segmental hepatectomy of segment 3 of liver was performed, and the histological report confirmed necrotic textiloma.

Textiloma represents a complication of all forms of surgery. It is a real, serious but preventable surgical complication, and could present with various complaints. Prevention of this condition can be achieved by meticulous count of surgical materials.

The embarrassment faced by the surgeon and the medico legal implications of this iatrogenic complication are tremendous and all preventive measures should be taken to avoid this as no excuse is justifiable.