Late intestinal obstruction due to intraluminal textiloma: a case report

Retained surgical foreign bodies are an infrequent but clinically significant complication, associated with considerable morbidity and potential medico-legal implications. Intraluminal location represents an exceptional presentation, with high diagnostic difficulty due to its nonspecific symptoms.

We present the case of a male patient in his fourth decade of life with a history of open cholecystectomy who developed intestinal obstruction secondary to an intraluminal textiloma in the distal ileum. The clinical presentation included progressive abdominal pain, vomiting, and absence of bowel movements. Diagnosis was established through abdominal radiography and computed tomography. Laparoscopic management was performed with enterotomy and removal of the foreign body, followed by enterorrhaphy, which was complicated by leakage requiring terminal ileostomy.

Textilomas are more frequently associated with emergency surgeries and prolonged procedures, with the pelvic cavity being the most common location (56%). Although magnetic resonance imaging may be useful in complex cases, plain radiography remains a key initial diagnostic tool. Gossypibomas should be considered a cause of mechanical obstruction, requiring prompt management once diagnosed.

Intraluminal textilomas should be considered in patients with a prior surgical history and obstructive symptoms. Management should be individualized according to clinical and local conditions. Prevention, through strict counting protocols, the use of radiopaque materials, and effective teamwork, remains the most effective strategy.