Surgical items retained in the abdominal cavity in diagnostic imaging tests: a series of 10 cases and literature review

Modrzejewski, Andrzej; Kaźmierczak, Konrad; Kowalik, Krzysztof; Grochal, Inga

doi:10.5114/pjr.2023.127668

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…As a result, 233 articles were screened for further potential. Then, 20 cases with intra-abdominal gossypibomas which were initially misdiagnosed as tumors in 19 literature (between 1979 to 2023) met the inclusion criteria ( 17 – 35 ). Overall, the relevant case reports focusing on this special population emerged rapidly in the past decade.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Laparoscopy-assisted resection for intra-abdominal gossypiboma masquerading as a jejunal tumor (with video)

Han,

Yang,

Dai

et al. 2023

Front. Oncol.

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IntroductionIntra-abdominal gossypiboma, a cotton-based retained foreign body after an abdominal surgery, is associated with various clinical manifestations and complications. Its infrequent occurrence and unpredictability make its early diagnosis particularly challenging. We herein present an atypical case of intra-abdominal gossypiboma mistaken for a jejunal tumor.Case presentationA 33-year-old female presented to the emergency room with an acute episode of progressive abdominal pain and distention, nausea, and vomiting for 20 hours. She had undergone an urgent cesarean section due to fetal tachycardia seven years prior. The initial diagnosis of small bowel obstruction (SBO) due to a jejunal tumor was established by computed tomography. Subsequent to successful medical management of the SBO, a laparoscopy-assisted resection of the mass and the adherent jejunal segment was conducted, culminating in a primary side-to-side jejunojejunostomy. Examination of the excised tissue revealed an approximately spherical fibrous mass, 6 × 6 × 5 cm in dimension, embedded in the jejunal wall, housing a 20 × 20-cm gauze. Postoperative recovery and routine follow-up ensued without complications.ConclusionIn light of this case, the need for clinicians to maintain an elevated awareness and suspicion of gossypiboma should be accentuated when evaluating an intra-abdominal mass, especially in patients with a prior history of high-risk laparotomy. Laparoscopic surgery stands out as a technically proficient and minimally invasive strategy for diagnosing and treating intra-abdominal gossypiboma. Besides, it is imperative to emphasize the importance of meticulous surgical procedures and postoperative protocols to prevent such oversights, reaffirming the need for consistent intraoperative counts and checks of surgical items.

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Section: Discussionmentioning

confidence: 99%

Case Report: Laparoscopy-assisted resection for intra-abdominal gossypiboma masquerading as a jejunal tumor (with video)

Han,

Yang,

Dai

et al. 2023

Front. Oncol.

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“…Notably, ultrasound is minimally effective in identifying retained surgical bodies. In a study by Modrzejewski et al, the authors reported that ultrasound could detect one in 25 RSB cases, thus yielding a sensitivity of 4% [ 14 ]. Conversely, CT is the most sensitive detection method and is usually obtained if an X-ray returns negative and there is high clinical suspicion [ 15 ].…”

Section: Retained Surgical Bodiesmentioning

confidence: 99%

Artificial intelligence in the detection of non-biological materials

Eibschutz,

Lu,

Abbassi

et al. 2024

Emerg Radiol

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Artificial Intelligence (AI) has emerged as a transformative force within medical imaging, making significant strides within emergency radiology. Presently, there is a strong reliance on radiologists to accurately diagnose and characterize foreign bodies in a timely fashion, a task that can be readily augmented with AI tools. This article will first explore the most common clinical scenarios involving foreign bodies, such as retained surgical instruments, open and penetrating injuries, catheter and tube malposition, and foreign body ingestion and aspiration. By initially exploring the existing imaging techniques employed for diagnosing these conditions, the potential role of AI in detecting non-biological materials can be better elucidated. Yet, the heterogeneous nature of foreign bodies and limited data availability complicates the development of computer-aided detection models. Despite these challenges, integrating AI can potentially decrease radiologist workload, enhance diagnostic accuracy, and improve patient outcomes.

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Unintentionally retained lap sponge mimicking an ovarian cyst two years after Caesarean section in a 37-year old patient: case report of a rare “never event” in Sudan

Elamin,

Masoud,

Mohamed Ali

et al. 2024

Patient Saf Surg

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Introduction This case report reports an unusual occurrence of gossypiboma, which refers to the accidental retention of surgical materials like sponges in the peritoneal cavity. The term is derived from “gossypium” (cotton) and “boma” (place of concealment). Its incidence varies with surgical type, posing diagnostic challenges due to nonspecific symptoms and equivocal imaging. Despite its rarity, gossypiboma poses significant risks, including intestinal obstruction and abscess formation. Case presentation A 37-year-old woman with ten previous pregnancies and an emergent caesarean section presented with abdominal pain. Examination and ultrasound suggested an ovarian cyst. During surgery, a 10 × 10 cm gauze-filled mass adherent to the ovary and jejunum was found. Postoperatively, she recovered well with no complications. The patient was treated with intravenous fluids and antibiotics for five days post-surgery and recovered without any complications. She was discharged from the hospital five days after the procedure. Conclusion To the best of our knowledge, this is the first reported case of gossypiboma in Sudan in 2024, highlighting diagnostic challenges and the need for preventive protocols. Root cause analysis of accidents, enhanced training, application of advanced technologies and a collaborative culture in the operating room can prevent the occurrence of such incidents. This case underscores the importance of meticulous surgical protocols and continuous improvement in safety measures to prevent retained surgical items, ensuring patient safety and optimal outcomes.

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Surgical items retained in the abdominal cavity in diagnostic imaging tests: a series of 10 cases and literature review

Cited by 4 publications

References 18 publications

Case Report: Laparoscopy-assisted resection for intra-abdominal gossypiboma masquerading as a jejunal tumor (with video)

Case Report: Laparoscopy-assisted resection for intra-abdominal gossypiboma masquerading as a jejunal tumor (with video)

Artificial intelligence in the detection of non-biological materials

Unintentionally retained lap sponge mimicking an ovarian cyst two years after Caesarean section in a 37-year old patient: case report of a rare “never event” in Sudan

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