Gossypiboma refers, as a term, to a retained surgical sponge. It is considered as a rare surgical complication which can occur despite precautions. We report a case of a 36-year-old woman who was admitted to our surgical department with symptoms of abdominal pain associated with episodes of nausea and vomiting that lasted for 2 months. Six months ago she had undergone a cesarean section in a private clinic. Computed tomography revealed a high-density mass occupying a portion of the intestinal lumen, which was reported as a “calcified parasite.” The patient was subjected to laparotomy. The intraoperative findings included signs of obstructive ileus and ileosigmoid fistula and a large sponge was found at the resected portion of the small intestine. Although gossypiboma is a rare entity, it should be included in the differential diagnosis.

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Background: Pretibial lacerations remain one of the commonest problems in plastic surgery. There is still no evidence of superiority of either a conservative or surgical approach for their management, nor any documentation regarding patients' performance following each approach. Methods: We conducted a retrospective study of all patients treated for pretibial lacerations/haematomas in our unit, from May 2013 till April 2014 who were offered surgical or conservative management. Conservative management included washout of wound and application of non-adhesive dressings; the patients were discharged home on the same day and followed up in dressing clinic. The Eastern Cooperative Oncology Group score was used to assess patients' well-being during healing time. Results: There were 38 patients; 21 opted for conservative management and 17 for skin grafting, after consultation. Overall, 66% of conservatively managed wounds were completely healed and patients were discharged. Mean healing time was 66.28 (13-172) days and required 3.43 (1-8) visits to the unit. In the surgically managed group, 88% of the patients had their wounds completely healed with a mean healing time of 69.5 (14-147) days and 5.87 (2-11) visits to the unit required. Of the conservatively managed patients, 55.6% scored 0 on the Eastern Cooperative Oncology Group scale, denoting fine health, while only 7.6% of the surgically managed patients scored zero. In total, 77.8% of the conservatively managed patients reported they would not have a chosen a skin graft if given the choice again. Conclusion: This study shows that satisfactory healing of pretibial lacerations may be achieved without surgical intervention in a high-risk group of patients, who reported good overall performance during healing time.

Background The suprascapular notch (SN) represents the point along the route of the suprascapular nerve (SSN) with the greatest potential risk for injury and compression. Thus, factors reducing the area of the notch have been postulated for suprascapular neuropathy development. Methods Thirty-one fresh-frozen shoulders were dissected. The contents of the SN were described according to four types as classified by Polguj et al and the middle-transverse diameter of the notch was measured. Also, the presence of an ossified superior transverse scapular ligament (STSL) was identified. Results The ligament was partially ossified in 8 specimens (25.8%), fully ossified in 6 (19.35%), and not ossified in the remaining 17 (54.85%). The mean middle-transverse diameter of the SN was 9.06 mm (standard deviation [SD] = 3.45). The corresponding for type-I notches was 8.64 mm (SD = 3.34), 8.86 mm (SD = 3.12) was for type-II, and 14.5 mm (SD = 1.02) was for type III. Middle-transverse diameter was shorter when an ossified ligament was present (mean = 5.10 mm, SD = 0.88 mm), comparing with a partially ossified ligament (mean =7.67 mm, SD = 2.24 mm) and a nonossified one (mean = 11.12 mm, SD = 2.92 mm). No statistically significant evidence was found that the middle-transverse diameter depends on the number of the elements, passing below the STSL. Conclusion Our results suggest that SSN compression could be more likely to occur when both suprascapular vessels pass through the notch. Compression of the nerve may also occur when an ossified transverse scapular ligament is present, resulting to significant reduction of the notch's area.