Textiloma complicating myomectomy: A case report
Hamidou Soumana Diaouga1, Maimouna Chaibou Yacouba1, Maina Oumara2
1Abdou Moumouni University, Department of Obstetrics and Gynecology, Maternity Issaka Gazobi in Niamey, Niger.
Introduction And Importance:
Textiloma or gossypiboma is a rare complication of pelvic surgery. It can mimic both, clinically, and radiologically an abscess, or a tumor, thus, making its diagnosis difficult and late. It can lead to a high morbidity and mortality rate for the patient and engages the surgeon's civil liability.
Case Presentation:
We report a case of textiloma following a myomectomy in a 42 year old patient treated in our department. Textiloma was diagnosed three years after myomectomy. Treatment consisted of a second laparotomy to remove the textiloma without complication.
Discussion:
Incidence of textiloma varies from 1/833 to 1/32.672 but more often encountered in African surgical practice. Systematic counts of instruments, sponges and needles is not yet usual in our operating room. Through the analysis of this case, we call on surgeons to be more vigilant in order to avoid this serious medical error.
Conclusion:
The aim of this study was to describe the intraoperative errors that led to the occurrence of the textiloma, depict the diagnostic difficulties of textiloma, and the medico-legal implications in a tertiary hospital in Niger.
Insights
Textiloma, a retained surgical sponge, is a rare but serious complication of pelvic surgery. Increased vigilance during surgery is crucial to prevent this potentially fatal medical error.
Area of Science:
- Surgical pathology
- Medical complications
Background:
- Textiloma (gossypiboma) is a rare complication following pelvic surgery.
- It can clinically and radiologically mimic abscesses or tumors, complicating diagnosis.
- High morbidity and mortality rates are associated with delayed diagnosis and treatment.
Observation:
- A case of textiloma is presented in a 42-year-old patient three years after myomectomy.
- Diagnosis was challenging due to its resemblance to other pelvic pathologies.
- Surgical removal via laparotomy was successfully performed without complications.
Findings:
- The incidence of textiloma varies, with higher prevalence noted in African surgical settings.
- Systematic counting of surgical instruments, sponges, and needles is not consistently practiced.
- Intraoperative errors contribute to textiloma occurrence, necessitating improved surgical protocols.
Implications:
- This case highlights diagnostic difficulties and medico-legal implications of textiloma.
- Surgeons must exercise increased vigilance to prevent retained surgical items.
- Adherence to systematic counts of surgical materials is essential to avoid this serious medical error.
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