Role of diagnostic laparoscopy in abdominal disorders with uncertain diagnosis: a rare case report

Female patient was hospitalized in the surgical of the Municipal Enterprise "2nd City Clinical Hospital of Poltava City Council" (Poltava, Ukraine) in 2023. The patient underwent a complete general clinical examination, a plain radiograph of the abdominal cavity, fibrogastroduodenoscopy, colonoscopy, ultrasound of the abdominal organs, CT scan of the abdominal organs. Diagnostic laparoscopy was performed to make a final diagnosis. A plain radiography of the abdominal cavity revealed no pathology. Ultrasound of the abdominal organs revealed a pelvic mass. A computed tomography scan revealed damage to the pelvic organs in the form of a neoplasm and an enlargement of the left ovary. The preliminary diagnosis was a pelvic tumor, tumor of the left ovary. Diagnostic laparoscopy was performed to make the diagnosis. A rounded formation was defined in Douglas space. The capsule of the formation was opened and pus was released. The abscess wall was opened, and a foreign body (gauze pad) was removed from the cavity. The patient was discharged from the hospital in satisfactory condition on the fifth day after surgery. The case we examined emphasizes that when assessing the nature of an intra-abdominal neoplasm, it is necessary to remember about foreign bodies, especially in patients after surgical interventions. Diagnostic laparoscopy is a technically advanced and minimally invasive procedure for the diagnosis and treatment of intra-abdominal gossypiboma.