Gossypiboma: A Dramatic Result of Human Error, Case Report and Literature Review

Abstract

Gossypiboma refers to a retained foreign object that was forgotten in the body cavity during an operation. It is a rare surgical complication that most commonly occurs after intraperitoneal abdominal emergency surgical procedures, but may also occur after virtually any type of operation. Gossypiboma can be confused with neoplastic lesions and abscess. Clinical examination and radiological findings may sometimes mislead the physician. We intend to present our cases, which is thought to be a kidney tumour and bladder cancer but resulted gossypiboma which is a condition that is caused by a forgotten sponge during the operation and it can mimic the cancer. During the operation, the team must work in coordination and be careful. Unnecessary operations in such situation can significantly increase the patient’s morbidity.

Intravesical textiloma mistook for bladder stone: A case report

“…4 Complications associated with textiloma include abscess, infection, visceral perforation, obstruction, fistula formation, and intraluminal migration. 1,8 In our case, the patient presented with lower urinary tract symptoms.…”

“…Emergency surgical procedures also pose a risk as sponge and instrument counting may not be a high priority. Other factors include obesity, poor communication among the team, incorrect or failed surgical count, and high blood loss intraoperatively 1,4,7 . In our case, the previous surgery was done in another hospital and therefore we could not find the associated factors which lead to retained gauze.…”

“…In ultrasound, it tends to present as echogenic masses or fragments. 1,4 A high index of suspicion is required as the textiloma may be confused with a F I G U R E 1 Scout film with suspected bladder stone (arrow). bladder mass or bladder stone.…”

“…4 Textiloma incidence tends to vary and is difficult to estimate as most of the cases are unreported due to medical-legal reasons. 1 Presence of intravesicular textiloma is rare; 5 however, some studies have estimated the incidence to be one in 100-3000 surgical cases for all surgical interventions and one in 1000-1500 for intra-abdominal operations. 6 Textiloma is associated with various factors such as complicated surgeries involving multiple teams and procedures, which increase the risk of information loss with each change of staff.…”

“…Textiloma in early stages are often asymptomatic and are diagnosed incidentally either during examination of other conditions or based on clinical suspicion. However, they can become clinically significant and cause non‐specific symptoms due to the body's inflammatory response to the foreign material 1,8 . Presentations of vesicular textiloma are usually related to those of lower urinary tract symptoms and urinary tract infections (UTI) such as include pain or irritation, nausea, and vomiting 4 .…”