Gossypiboma Presenting as Coloduodenal Fistula – Report of a Rare Case With Review of Literature

Abstract

The term gossypiboma is used to describe a mass of cotton matrix left behind in a body cavity intraoperatively. The most common site reported is the abdominal cavity. It can present with abscess, intestinal obstruction, malabsorption, gastrointestinal hemorrhage, and fistulas. A 37-year-old woman presented with pain in the right hypochondrium for 2 months following open cholecystectomy. As she did not improve with proton pump inhibitors, an esophagogastroduodenoscopy (EGD) was done, which showed a possible gauze piece stained with bile in the first part of the duodenum. Contrast-enhanced computed tomography (CECT) of the abdomen revealed an abnormal fistulous communication of the first part of duodenum with proximal transverse colon, with a hypodense, mottled lesion within the lumen of the proximal transverse colon plugging the fistula, suggestive of a gossypiboma. Excision of the coloduodenal fistula, primary duodenal repair, and feeding jejunostomy was done. The patient recovered well and is now tolerating normal diet. Coloduodenal fistula is usually caused by Crohn's disease, malignancy, right-sided diverticulitis, and gall stone disease. Isolated coloduodenal fistula due to gossypiboma has not been reported in the literature so far to the best of our knowledge. We report this case of coloduodenal fistula secondary to gossypiboma for its rarity and diagnostic challenge.

Post Cholecystectomy Gossypiboma Mimicking a Liver Hydatid Cyst: Comprehensive Literature Review

“…Gossypiboma is a rare complication of surgery, but leads to serious medico-legal problems between patients and doctors and because of this, it should be considered important. Gossypiboma is most commonly seen after abdominopelvic cavities surgery, but it can also follow thoracic, orthopedic, urological and neurosurgical procedures ( 2 , 4 , 33 ).…”

A heterogeneous liver lesion in a 48-year-old woman

“…A gossypiboma, which is a rare surgical complication, can cause significant morbidity and mortality rates. It can be seen as an intra-abdominal abscess in the early postoperative period or can be incidentally detected (1). Diagnosing a gossypiboma may be difficult as it may have nonspecific symptoms and appear years after surgery.…”

<p>Abdominal Intraluminal Gossypiboma: Demographics, Predictors of Intraluminal Site, Diagnostic and Treatment Measures</p>

“…Terms that have also been used to describe this situation are textiloma, cottonoid, cottonballoma, or gauzeoma. 1,2 The term gossypiboma derives from the Latin word "gossypium" and the Swahili word "boma," which means cotton and a "place of concealment," respectively. 1,2 Intra-abdominal gossypiboma is the term used when a sponge is accidentally left in the abdominal cavity.…”

“…1,2 The term gossypiboma derives from the Latin word "gossypium" and the Swahili word "boma," which means cotton and a "place of concealment," respectively. 1,2 Intra-abdominal gossypiboma is the term used when a sponge is accidentally left in the abdominal cavity. 3 This complication can be serious and associated with life-changing outcomes.…”