2018
DOI: 10.1136/bcr-2017-221537
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Gossypiboma: a ghastly find

Abstract: A gossypiboma is a mass within a patient’s body comprising a cotton matrix surrounded by a foreign body granuloma. We describe an unusual presentation of a gossypiboma presenting in a 32-year-old man with acute epigastric pain and haematemesis. His surgical history revealed an emergency laparotomy following a road traffic accident 16 years ago. Initial gastroscopy showed extrinsic stomach compression. An abdominal ultrasound scan followed by a CT scan evidenced a large, well-defined, predominantly cystic mass … Show more

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Cited by 2 publications
(3 citation statements)
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“…6 The treatment of Gossypiboma consists of surgical resection by laparotomy, with the possibility of using laparoscopic or percutaneous removal in selected cases, when allowed by the adhesions formed. 4 This case highlights two teaching points. First, that this entity should always be considered in every patient who has symptoms located in the same place where there is a surgical history, and second, that emphasis should be placed on surgical safety strategies, in order to avoid this type of events that cause morbidity, mortality and high-economic costs.…”
mentioning
confidence: 89%
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“…6 The treatment of Gossypiboma consists of surgical resection by laparotomy, with the possibility of using laparoscopic or percutaneous removal in selected cases, when allowed by the adhesions formed. 4 This case highlights two teaching points. First, that this entity should always be considered in every patient who has symptoms located in the same place where there is a surgical history, and second, that emphasis should be placed on surgical safety strategies, in order to avoid this type of events that cause morbidity, mortality and high-economic costs.…”
mentioning
confidence: 89%
“…When a dressing is accidentally left inside the body after a surgical procedure, two types of responses can be triggered: exudative fibrinous response (development of fever and pain in the early postoperative period and progression to serious complications such as abscess or fistula formation) or aseptic response (causes adhesion to surrounding tissue, encapsulation, organization and subsequent formation of an iatrogenic granuloma, without causing inflammation). 4 During the assessment of non-specific symptoms, it is necessary to consider the location of previous surgeries and the location of the current symptomatology, regardless of how long ago the surgery took place, since as observed in this case, the onset of the gossypiboma complication took 5 years. In particular, the abdomen and pelvis are the regions where foreign bodies are most frequently left behind unintentionally during surgery (28,9%), followed by the vagina (20.2%) and joints (13.6%), 2 where gynaecology and obstetrics (25.9%), general surgery (19.8%) and orthopaedics (18.7%) are the main specialties involved in this event.…”
mentioning
confidence: 91%
“…7 The treatment consists of laparotomy, with the possibility of using laparoscopic or percutaneous removal in selected cases when allowed by the surrounding adhesions. 8 A high index of suspicion is required to diagnose such a rare entity. To forestall such adverse events, we emphasize a standard routine procedure like strict sponge tally and meticulous scrutiny of the peritoneal cavity prior to closure.…”
mentioning
confidence: 99%