Retained surgical item (Gossypiboma): a case report and literature review
Mohammed A Alsuhaimi1, Hallah S Alghamdi1, Sarah A Alshaiji1
1Dammam Medical Complex, Dammam, Saudi Arabia.
Abstract:
Retained surgical item is a known incidental surgical complication that is a mass of a sponge. This cotton matrix is left behind in the body cavity after surgical procedures. It is an incidental, rare medical error.
Case Presentation:
Here, the authors present a case of a 30-year-old woman who had undergone a cesarean section 2 months ago and presented with the cardinal symptoms of small bowel obstruction. A computerized abdominal tomography (CT) scan showed a well-defined tubular hyperdense structure adherent to the anterior abdominal wall that exerts a mass effect on the adjacent small bowel loops. Following the computerized abdominal tomography results, an exploratory laparotomy resection and anastomosis of a small segment of the ileum were performed. The postoperative period was uneventful, and the patient has remained disease-free to date.
Clinical Discussion:
Because it is not anticipated, and its clinical manifestations are variable, it is frequently misdiagnosed, and often unnecessary radical surgical procedures are performed.
Conclusion:
It should be considered in the differential diagnosis of any postoperative case with an unresolved or unusual presentation.
Insights
A retained surgical sponge, a rare complication, can cause bowel obstruction. Early consideration in unusual postoperative presentations is crucial for accurate diagnosis and avoiding further surgery.
Area of Science:
- Medical Error
- Surgical Complications
- Gastroenterology
Background:
- Retained surgical items, such as sponges, are infrequent but serious complications.
- These items form a cotton matrix within body cavities, leading to potential issues.
Purpose of the Study:
- To present a case of retained surgical sponge causing small bowel obstruction.
- To highlight the importance of considering this in differential diagnoses.
Main Methods:
- Case presentation of a 30-year-old woman post-cesarean section.
- Diagnostic imaging using computerized abdominal tomography (CT).
- Surgical intervention: exploratory laparotomy with resection and anastomosis.
Main Results:
- CT revealed a hyperdense structure causing mass effect on small bowel loops.
- Surgical removal of the retained item was successful.
- Patient experienced an uneventful recovery and remained disease-free.
Conclusions:
- Retained surgical sponges can present with variable and often misdiagnosed symptoms.
- This complication should be included in the differential diagnosis for unusual postoperative presentations.
- Prompt diagnosis and intervention are key to patient recovery.
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