Retained Intra-Abdominal Hemostatic Materials: A Rare Cause of Abscess, Intestinal Obstruction, and Intestinal Fistula

Abstract

Background: A retained intra-abdominal surgical sponge is always followed by foreign body granuloma and serious complications such as perforation, intra-abdominal abscess, intestinal obstruction, and intestinal fistula. Hemostatic materials have become increasingly popular and are used to control intra-abdominal hemorrhage, remaining in the abdominal cavity after surgery. Usually there are no symptoms in patients who have retained hemostatic materials because these materials are bioabsorbable and cause no harm. However, if the body fails to absorb the hemostatic materials completely, the retained materials will cause the same problems as the gossypiboma does. Case Presentation: We report a 37-year-old male who underwent emergency surgery because of closed abdominal trauma, rectum rupture, and intra-abdominal hemorrhage after an automobile accident. Partial rectectomy with sigmoid stoma was performed, however, the hemostatic materials used during the emergency surgery became calcified and caused damage to the intestine, leading to severe post-operative complications including intra-abdominal abscess, intestinal obstruction, and intestinal fistula. The patient was then transferred to our hospital and cured after the removal of the foreign bodies, resection of the terminal ileum fistula with anastomosis, and colostomy closure. Conclusions: Surgeons need to be cautious when leaving hemostatic materials in the abdominal cavity even if they are bioabsorbable.