An unusual late sequel to hysterectomy

Area of Science:

• Surgical pathology
• Medical imaging
• Patient safety

Background:

• Retained surgical items are a known complication in surgery.
• Foreign body granulomas can develop around retained materials.
• Non-opaque materials pose a diagnostic challenge on imaging.

Observation:

• A large infected foreign body granuloma was identified 9 years post-hysterectomy.
• The granuloma was associated with a retained non-opaque surgical swab.
• Abdominal radiography and CT scans revealed gas collections within the abdominal mass.

Findings:

• The granuloma's size and infection were significant.
• Gas within the mass suggested a complex infectious or necrotic process.
• The non-opaque nature of the swab hindered early detection.

Implications:

• Emphasizes the critical importance of using radioopaque swabs in all surgical procedures.
• Highlights the potential for delayed diagnosis and severe complications from retained foreign bodies.
• Underscores the need for meticulous surgical counts and postoperative vigilance.