Gossypiboma and Surgeon- Current Medicolegal Aspect – A Review

Biswas, Rabi Sankar; Ganguly, Shirshendu; Saha, Makhan; Saha, Subhasis; Mukherjee, Subhabrata; Ayaz, Asif

doi:10.1007/s12262-012-0446-3

Cited by 42 publications

(41 citation statements)

References 19 publications

(21 reference statements)

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“…If it were done earlier, it probably would have helped in patient management, thus probably it is wise to get a CT done early if such cases are encountered. The measures to prevent such complication include maintaining strict count of surgical sponges, a meticulous exploration of surgical site before closure and use of radio-opaque markers on surgical sponges 6. In our patient, there were no radio-opaque markers on the surgical sponge.…”

Section: Discussionmentioning

confidence: 70%

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Gossypiboma masquerading as nephrocutaneous fistula

Pandey¹,

Aggarwal

Singh

et al. 2018

BMJ Case Reports

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Nephrocutaneous fistula is a rare complication of surgical procedures involving the kidney. Fistula formation is also a complication seen in gossypiboma. We present the case of a patient who was initially suspected to have nephrocutaneous fistula after open pyelolithotomy. Later while undergoing open resection of fistula, he was found to have a retained surgical sponge (gossypiboma) near the lower pole of kidney. Gossypiboma is a term used for mass formed around a surgical sponge accidentally left in the body. It is most of the times not diagnosed by radiological imaging and thus results in unnecessary investigations to rule out other causes for the patient’s symptoms. Having a high index of suspicion may lead to an earlier diagnosis. But the prevention of gossypiboma is of the utmost importance. A meticulous approach while operating by the surgeon and operating rooms staff is very important in doing so.

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Section: Discussionmentioning

confidence: 70%

“…It may be asymptomatic in one-third cases. The interval for symptoms to arise may range from few days to 24 years 6. When symptomatic, a very high index of suspicion is required to make a diagnosis of gossypiboma.…”

Section: Discussionmentioning

confidence: 99%

Gossypiboma masquerading as nephrocutaneous fistula

Pandey¹,

Aggarwal

Singh

et al. 2018

BMJ Case Reports

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“…The more common form of presentation however is the patient who has had a chronic gossypiboma secondary to an aseptic fibrinous response with formation of adhesions and encapsulation leading to a walled off fibrinous mass as in our case. It can be picked up months or even years after initial surgery [6]. The 2009 World Health Organization guidelines for safe surgical procedures advocates only using radiopaque detectable sponges in body cavities [7].…”

Section: Discussionmentioning

confidence: 99%

Gossypiboma Presenting as an Atypical Intra-Abdominal Cyst: A Case Report

Dan¹,

Ramraj²,

Solomon³

et al. 2014

Health

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Gossypibomas are generally retained surgical sponges, and are usually a rare occurrence. They are diagnostic dilemmas with an incidence ranging from 1 in 8000 to 1 in 18,000 surgeries. However the incidence of this problem is on the rise and the clinician needs to have a high index of suspicion to make an accurate diagnosis. We reported the case of a 50-year-old male patient who presented with a 6-month history of vague epigastric discomfort, early satiety and nausea. Further investigation revealed an intra-abdominal cyst that proved to be secondary to a retained laparotomy sponge and was treated laparoscopically. This is usually an unanticipated surgical misadventure which is often preventable, with significant associated stigma for the surgical professional involved. Unfortunately it leads to extensive and often unnecessary surgical intervention. The condition can be managed conservatively or surgically. Our case report demonstrates the use of laparoscopy for the successful management of intra-abdominal gossypibomas and represents the first reported case of laparoscopic management of a gossypiboma in the Caribbean setting. It also demonstrates both the acute and delayed presentations of gossypibomas in the same patient.

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“…Accordingly, the spongecount report should be verified and a rou tine cavity exploration should be performed before clo sure. For the health of the patient and because of legal implications, 10 we think that every retained sponge or gauze pad in the cardiovascular operating field should be removed as soon as it is discovered.…”

Section: Case Reportsmentioning

confidence: 99%