Incidental gossypiboma on contrast enema study

Area of Science:

• Oncology
• Infectious Diseases
• Surgical Pathology

Background:

• Human Papillomavirus (HPV) is a known oncogenic virus.
• HIV/HCV coinfection presents unique challenges in managing HPV-related malignancies.
• Squamous cell carcinoma of the vulva requires comprehensive treatment strategies.

Observation:

• A 50-year-old woman with HIV/HCV coinfection underwent surgery for HPV-related vulvar cancer.
• Postoperatively, she developed a rectovaginal fistula and required a diverting colostomy.
• A contrast enema revealed a radiodense marker thread, indicative of a retained surgical sponge.

Findings:

• The retained surgical sponge was identified via contrast enema, a crucial diagnostic imaging modality.
• This case highlights a rare but serious complication following vulvar cancer surgery.
• The presence of a retained surgical item can lead to fistulas and other adverse outcomes.

Implications:

• Increased awareness among clinicians regarding retained surgical items is crucial, especially in complex cases.
• The importance of meticulous surgical counts and postoperative surveillance is underscored.
• Advanced imaging techniques play a vital role in diagnosing and managing unexpected surgical complications.