A 20-Year-Old Gossypiboma Causing Small Bowel Obstruction

Abstract

Retained foreign bodies including gossypiboma could be silent for years. However, in some cases, it can lead to major complications. Gossypiboma is not frequently reported for multiple reasons, including nonspecific presentation clinically and radiologically, and ethical issues. We present a case of a gossypiboma that was retained for more than 20 years causing a severe intestinal obstruction for an elderly female. The intestinal obstruction was initially thought to be adhesive in nature and was managed initially conservatively, but with failure to improve, the patient was taken for exploratory laparotomy, and the foreign body was found attached to the root of the mesentery posterior to the transverse colon. This case sheds light on the fact that although surgical tools are of great utility, they must be managed with utmost care to prevent complications and secure patients' safety.

Gossypiboma, the Never Event; a Case Report

“…Meanwhile, the most common places to be found are the abdomen, thorax, and pelvis [2]; in this case, the retained gauze was within the abdominal cavity and the patient presented as a case of complete small bowel obstruction (2). While the reporting of such cases is lacking because of the fear of medico-legal pursuits or even reputation damage among hospital staff [3] [5] [8] [9]. The presenting symptoms vary widely from abdominal pain, vomiting, and abdominal mass, or it can even mimic neoplastic tumors if it is found in the extremities.…”

“…On the other hand, the morbidities to the patient are devastating and the cost to the hospital is exhausting financially, and it is easily preventable from the first operation. It is a human factor error and it will always be there, nevertheless we try to minimize it the most [3]…”

“…The term Gossypioma in the literature indicates a retained surgical sponge or gauze which accidentally left behind in a prior surgery [1] [2]. Misplacing a sponge inside the patient is a tremendous mistake and can be easily preventable; as it's classified as a human factor error [2] [3]. The incidence is severely underreported in the literature due to several points such as legal consequences, and the reputation of the hospital or even the surgeons.…”