Surgical materials retained in the abdomen after surgery

Abstract

The authors present seven cases of surgical drape left in body cavities during surgical operations. The most common symptoms reported by these patients are analysed and the consequences of leaving a foreign body in the abdominal cavity are summarised. In the majority of cases, the time elapsed from the operation to the detection of the foreign body was an average of 17 months. In one case, the foreign body remained in the abdomen for 7 years. The most common symptom reported by patients was abdominal pain. Some patients also developed wound healing disorders with leakage of pus from the wound, fever, nausea and vomiting, weight loss or intermittent tarry stools. In most cases, the foreign body required reoperation to remove it. Major surgery with stoma creation or bowel resection was required. In one case described, the consequence of leaving a surgical drape was the death of the patient. In three cases, there was spontaneous expulsion of the surgical sling by the patient by natural means.

Unraveling the Enigma of Gossypiboma: A Series of 14 Cases Highlighting the Prevalence, Root Causes, and Outcomes in Resource-Limited Settings

“…All retained surgical sponges were treated with open surgical procedures in this study. This approach was similar to previous reports emphasizing that all gossypiboma should be treated through surgical removal [ 21 ]. However, surgical intervention may not always be necessary.…”

“…Postoperative complications after abdominal surgeries have been associated with negative economic impact, increased morbidity, extended postoperative hospital stay, readmission, sepsis, and death [ 20 ]. The clinical presentation of gossypiboma is highly heterogeneous, and the type and severity of symptoms are attributed to the body’s reaction to retained sponge material [ 21 ]. Retained surgical sponges can cause early and late complications, including pain, infections, hemorrhage, obstruction, peritonitis, organ damage, nausea and vomiting, wound dehiscence, and delayed healing, while late complications include adhesions, fistula formation, abscess formation, bowel perforation, chronic pain, sepsis, and nutritional deficiencies [ 22 ].…”

“…Furthermore, fistula and intestinal obstruction may shortly lead to fast discovery. In rare cases, gauze may migrate downstream through the gastrointestinal tract and be expelled naturally in the feces [ 21 ]. In a comprehensive analysis of 254 case reports involving retained surgical materials, abdominal pain, and mass were the most commonly reported symptoms [ 5 ].…”

“…The leading causes of radiology X-ray misdiagnosis are frequently due to inaccurate interpretations of metallic shadows, radiolucent materials, and unidentified foreign items. On the other hand, US misinterpretation is primarily due to unfamiliarity with textiloma imaging, its spherical shape, fluid reservoirs, and inflammatory infiltration, potentially indicating hematoma or cancer [ 21 ].…”

Gossypiboma Mimicking an Ovarian Cyst, Discovered Two Years Post- Cesarean Section: A Case Report

“…The intraperitoneal cavity is where gossypibomas are most frequently found (3). There is a 0.001-0.1% chance of leaving a foreign body in the surgical eld after a single procedure, and 90% of the objects that are left behind are soft foreign bodies like gauze or surgical sponges (4). However, the real number of cases is still underestimated.…”