Gossypiboma: the failure of a successful intervention

Abstract

If successful surgery is the primary quest of any surgeon, unintentionally leaving behind surgical items in the operative field remains his most feared obsession. This rare but dramatic accident can lead to potentially fatal complications and turn both lives of the surgeon and the patient upside down. We present the case of a 29-year-old female patient who presented to the ER with three days history of severe diffuse abdominal pain associated with fever, biological inflammatory syndrome and well-tolerated iron deficiency anaemia. She had no past medical history except for a lower segment cesarean section 5 months ago. Abdominal MRI allowed the diagnosis of two gossypibomas responsible for two intra-abdominal collections. An emergency laparotomy allowed the removal of these foreign bodies and the management of their serious complications of intestinal perforation by the construction of a double intestinal stoma. The patient made a post-operative uneventful recovery. This observation emphasizes the need to raise the practitioner´s awareness about this differential diagnosis in every case of any poorly localized abdominal pain occurring after surgery.

Gossypiboma, the Hidden Enemy of an Emergency Cesarean Hysterectomy—Case Report and Review of the Literature

“…The most frequent possible complications described secondary to the presence of gossypiboma were represented by fistulas (19.29%) [ 10 , 13 , 19 , 20 , 23 , 27 , 32 , 33 , 37 , 50 ], perforations (12.28%) [ 1 , 26 , 29 , 44 , 45 , 51 , 53 ], obstructions (5.26%) [ 11 , 32 , 37 ], and bladder injuries [ 34 ] ( Table 3 ).…”

“…Completing the imaging evaluation using CT and MRI increases the chances of preoperative diagnosis of this pathology [8,42] (Table 2). The most frequent possible complications described secondary to the presence of gossypiboma were represented by fistulas (19.29%) [10,13,19,20,23,27,32,33,37,50], perforations (12.28%) [1,26,29,44,45,51,53], obstructions (5.26%) [11,32,37], and bladder injuries [34] (Table 3). The therapeutic strategy of gossypiboma is surgical, being differentiated depending on the diagnosis time and possible complications' association.…”

Gossypiboma discovered 24 years after prostate surgery, a forgotten but never forgiven complication

“…Patients may present within days or even years; most will remain asymptomatic for a long time [ 5 , 6 ]. However, they may present with obstruction, peritonitis, adhesions, abscesses or erosions [ 5 , 7 ]. Diagnosis is usually made by imaging; plain radiographs may show a radiopaque marker if it is impregnated in the surgical gauze, and ultrasound may show a cystic mass with heterogeneous contents [ 6 ].…”

“…Diagnosis is usually made by imaging; plain radiographs may show a radiopaque marker if it is impregnated in the surgical gauze, and ultrasound may show a cystic mass with heterogeneous contents [ 6 ]. CT is the most commonly used imaging method; it can reveal surrounding organ involvement and aid in perioperative planning [ 7 ], as we did with our patient.…”

Atypical presentation of vesicouterine fistula (Youssef’s syndrome) post-caesarean gossypiboma: a case report

“…7 Gossypiboma is a term used to describe nonabsorbable surgical material such as gauze which is forgotten inadvertently during surgical intervention. 8,9 Though rare, it has been implicated in the causation of patient morbidities and even mortality if not recognized and promptly managed. 10 In a fifteen-year review of 12304 surgical cases managed in southeastern Nigeria, 4 cases accounting for 0.03% were found to have gossypiboma.…”