Retained surgical sponge mimicking GIST: Laparoscopic diagnosis and removal 34 years after original surgery

Abstract

The term gossypiboma denotes a cotton foreign body retained inside the patient during surgery, a rare surgical complication. The symptoms following this entity are non-specific, such as pain, palpable mass and fever, which make clinical diagnosis difficult. The computerized tomography (CT) scan is the most useful method for diagnosis; however, sometimes the preoperative diagnosis remains uncertain even after the imaging exam. In that case, laparoscopy arises as a valuable diagnostic tool, as well as a prompt treatment option. However, when diagnosis is made years after the original surgery, the laparoscopic approach becomes harder. Our patient presented without clear symptoms, remaining asymptomatic for 34 years. The CT scan presumptive diagnosis was a gastrointestinal stromal tumour, and laparoscopy was performed providing an accurate diagnosis and treatment in the same surgical time.

Laparoscopic Removal of Gossypiboma

“…Justo et al detected the retained item as a gastrointestinal stromal tumour, after 34 years from their first operation due to peptic ulcer surgery. During laparoscopy, they noticed gossypiboma and removed the mass laparoscopically [ 17 ]. Sista et al noticed gossypiboma in their 40-year-old case after 9 years from her elective caesarean section and removed the mass which was approximately 20 cm in diameter by minilaparotomy through Pfannenstiel incision.…”