Gossypibomas Mimicking a Splenic Hydatid Cyst and Ileal Tumor A Case Report and Literature Review

Department of Surgery, Diyarbakir Education and Research Hospital, 21400 Kayapinar, Diyarbakir, Turkey.
Journal of Gastrointestinal Surgery (Impact Factor: 2.8). 07/2011; 15(11):2101-7. DOI: 10.1007/s11605-011-1592-9
Source: PubMed


Gossypiboma is a term used to describe a retained surgical swab in the body after a surgical procedure. Gossypiboma is a rare surgical complication, but can cause significant morbidity and mortality. It may be a diagnostic dilemma with associated medico-legal implications, and is usually discovered during the first few days after surgery; however, it may remain undetected for many years.
We present a gossypiboma case immigrating to small intestine, as well as a literature review of studies published in the English language on intraluminal migration of gossypiboma, accessed through PubMed and Google Scholar databases.
Case of a 51-year-old man who was admitted due to vomiting, abdominal distension, and pain. He had a history of abdominal trauma 8 years previously, and surgery had been performed at another hospital. The physical examination revealed muscular guarding and rebound tenderness in the right lower quadrant. A splenic hydatid cyst and ileal calcified mass were suspected based on results of abdominal computed tomography. Therefore, a laparotomy was performed. Segmental ileal resection, end-to-end anastomosis, and splenectomy were performed. The final diagnosis was gossypiboma in both the spleen and ileum. We performed a systemic review of the English-language literature between 2000 and 2010 in PubMed and Google Scholar, and we found 45 cases of transmural migration of surgical sponges following abdominal surgery. Three cases in which the gossypiboma was located in the spleen are also discussed.
Gossypiboma should be considered as a differential diagnosis of any postoperative patient who presents with pain, infection, or a palpable mass.

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Available from: Yusuf Yagmur, Jul 09, 2014
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    • "A thorough medical history, which can reveal previous surgery, and lab tests together with imaging (ultrasonography , computed tomography, or magnetic resonance) are crucial elements for diagnosis of textiloma [11]. Differential diagnosis includes tumor; cysts, parasitic and otherwise; hematoma, and inflammatory tumor [4] [13] [18] [19], we ruled out CE based on the knowledge of the echinococcal cyst structure (Figure 4). The origin of the patient from an endemic area (Southern Italy) and the negative serologic tests, that would have been in accordance with the cyst being inactive (although calcifications can be found at virtually any stage of the cyst history [20] [21]), were two confounding factors. "
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    ABSTRACT: Textiloma or gossypiboma is a retained surgical swab in the body after an operation and is a complication that can remain undetected for many years and may represent a diagnostic dilemma depending on its location. It may be confused with several focal lesions and an accurate history taking, combined with clinical and instrumental data, is key to suspecting the diagnosis. We report a case of abdominal textiloma that was initially misdiagnosed as echinococcal cyst and discuss the differential diagnosis based on sonographic features and the WHO-IWGE classification.
    Full-text · Article · Feb 2013
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    • "One hundred seventy eight (178) reports from the period (1978-2011) were identified via the National Library of Medicine′s Medline. Review of literature and Medline search revealed 45 reported cases of trans mural migration of surgical sponges following abdominal surgery during period of 2000-2010.[1] Incidence of Retained surgical sponge or gossypiboma occurs at a one per 100-3000 operations;[2] however, surgeons may not report these events for fear of litigation and adverse publicity therefore true incidence will never be known. "
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    ABSTRACT: Forgotten foreign bodies, such as cotton sponges, gauze, or instruments, after any surgical procedure is considered a misadventure but avoidable complication. "Gossypiboma" denotes a mass of cotton that is accidentally retained in the body postoperatively. This study's goal was to systematically review the literature on retained sponges to identify incidence, site of occurrence, time of discovery, methods for detection, pathogenesis for intraluminal migration and risk factors. Author is reporting this case in which a 45-year old woman presented with features of chronic pain abdomen following abdominal hysterectomy (first surgery) which lead to open cholecystectomy (second surgery) after two and half year of first surgery. As patients continued to have persistent abdominal pain in spite of second surgery patient went to medical gastroenterologist who advised her series of tests including colonoscopy examination. The whole colon was normal on examination but on examination of terminal portion of small bowel some intraluminal mass was visualized. Attempt to retrieve this mass lead to iatrogenic ileal perforation.
    Full-text · Article · Apr 2012
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    ABSTRACT: Gossypiboma or textiloma are two terms used to describe any cotton matrix such as gauze pads left behind during an operation in the body cavities. They may lead to infections or abscess formations, or may mimic malignant tumours. Here, we present a woman with a history of a previous operation on her thorax who became symptomatic 25 years after the operation because of retained surgical gauzes covered by fibrinous materials with adhesions to the left lung. The cotton matrix had developed into a gossypiboma mimicking a mediastinal tumour.
    Preview · Article · Jul 2012 · Interactive Cardiovascular and Thoracic Surgery
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