Gossypiboma of the Abdomen

Abstract

Intra-abdominal cysts may rise from a variety of organs. However, foreign-body reaction and cyst formation should be considered in the differential diagnosis. In this report, we describe the finding of a preoperatively undetected gossypiboma. A gossypiboma is a mass within the body that is composed of a cotton matrix; in this case, an unmarked laparotomy sponge. The evaluation, findings, and prevention of gossypiboma are discussed.

Gossypiboma: Retained Surgical Sponge After Total Abdominal Hysterectomy with Spontaneous Transurethral Partial Extrusion

“…Following retention, they have revealed themselves as intra-abdominal masses, in intestinal fistulae, by intestinal obstruction after transmural migration into the intestinal lumen, by protrusion into the gastric antrum from the first part of the duodenum, and into the rectum.3 Most cases present as a mass or with subacute intestinal obstruction, although rarely do they result in fistulas, free perforation or even extrusion [7].…”

Gossypiboma treated by colonoscopy

“…On plain radiographs, a sponge may appear as a whirl-like pattern, but this is uncommon [2,6,7,8]. Computed tomography similarly demonstrates a well-circumscribed mass with varying densities internally (air and soft tissue) [2,6,7,8].…”

“…The rim of the mass usually demonstrates dense, prolonged enhancement after the administration of contrast [6,7]. Irregular central or rim calcifications may form after an extended period of time [2,6,7,8].…”

“…The true incidence is difficult to determine, but has been reported to occur in 1 per 1,000 celiotomies [1]. The mindful surgeon remains the key to prevention; however, gossypibomas occur nonetheless despite accurate sponge counts [2]. Treatment options in the past were limited to laparotomy.…”

Experiência clínica de cirurgiões brasileiros com a retenção inadvertida de corpos estranhos após procedimentos operatórios

“…Com o passar dos anos, eles podem se desintegrar ou, até, ser confundidos com calcificações ou extravasamento de contraste radiológico, mesmo em tomografias. Além disso, a maioria dos países subdesenvolvidos ainda não os utiliza, alegando serem economicamente inviáveis [32][33][34] . Porém, ainda que fossem amplamente difundidos e facilmente detectáveis, para que os marcadores tivessem alguma utilidade preventiva, dependeriam da realização de radiografias intraoperatórias, que também trazem desafios que lhes são inerentes.…”