Gossypiboma of the Abdomen and Pelvis; A Recurring Error

Maranya, Gilbert; Maganga, Heltam; Mwero, Bernard

doi:10.4314/aas.v14i1.9

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…The risk for gossypiboma has been found to be higher in emergency surgeries, prolonged surgeries, surgeries involving more than one major procedure or more than one surgical team, improper or incorrect surgical swab counts, unexpected intraoperative occurrences and high intraoperative blood loss [5]. Since practically nothing was known about the initial surgery the patient had (except that it was an elective hysterectomy), the occurrence of any of these risk factors could not be ascertained.…”

Section: Discussionmentioning

confidence: 99%

Gossypiboma: A case report

KO¹,

SB²,

AI³

et al. 2021

J Clin Images Med Case Rep

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This case underscores the need for clinicians to bear the possibil‑ ity of gossypiboma in mind when patients who have had abdominal surgery in the recent past present with unresolving abdominal pain. This 46 year old woman who had an elective hysterectomy done three months earlier presented with unresolving abdominal pain of three months and lower abdominal distension of a day duration. Fol‑ lowing exploratory laparotomy, an 18 cm by 18 cm towel was recov‑ ered from her peritoneal cavity. She subsequently developed fecal fistula which was successfully managed conservatively and was dis‑ charged in good condition on 20th post-operative day. Gossypiboma is a rare but grave complication of abdominal and pelvic surgeries with attendant significant morbidity or even mortal‑ ity. Adequate attention to patient care processes may reduce its oc‑ currence and high index of suspicion is needed for its diagnosis. Keywords: abdominal sponge; gossypiboma; intra‑abdominal.

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Section: Discussionmentioning

confidence: 99%

Gossypiboma: A case report

KO¹,

SB²,

AI³

et al. 2021

J Clin Images Med Case Rep

View full text Add to dashboard Cite

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Gossypiboma – “string of pearls” sign may be diagnostic: A case report

Odion,

Okomayin,

Tagar

et al. 2023

ANMRP

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Gossypiboma is a retained non-absorbable material composed of the common cotton matrix. It is an unexpected surgeon’s “never event” with serious medicolegal implications. We present a case of a young woman who came to our facility 6 days after an emergency cesarean section for prolonged labor in a private hospital with features in keeping with post-operative peritonitis. Pre-operative abdominal radiographs revealed bowel loops that were majorly gasless, except for a row of small round pockets of gas running horizontally across the right hemi-abdomen, giving the “string-of-pearls” sign. She was optimized for an emergency laparotomy. The intraoperative finding was a retained sponge walled off by loops of the dilated small bowel. Within this cavity was found 400 mL of pus. The sponge was removed with ease and the pus was drained with a good post-operative outcome. The finding of a gasless abdomen on a plain radiograph is a thing of concern as small bowel obstruction with or without bowel ischemia is the most feared cause of a gasless abdomen which can be life threatening. Therefore, a gossypiboma should always be considered in a post-surgical patient with abdominal radiographic findings of a gasless abdomen; in particular, with the “string-of-pearls” appearance present. This case highlights that retention of foreign bodies after surgery is a persisting “never event” and as such there is the need to comply with current recommendations on the prevention of retained foreign bodies. The most important approach to reducing the incidence of gossypiboma is prevention. Thus, awareness of this problem is mandatory to avoid unnecessary morbidities.

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Gossypiboma of the Abdomen and Pelvis; A Recurring Error

Cited by 2 publications

References 8 publications

Gossypiboma: A case report

Gossypiboma: A case report

Gossypiboma – “string of pearls” sign may be diagnostic: A case report

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