Intractable duodenal ulcer caused by transmural migration of gossypiboma into the duodenum - a case report and literature review

BMC Surgery

Cheng-Chung Wu³  Chun-Fang Tung²  Cheng-Chan Yu³  Yun-Xiao Lv¹ 

[1] Department of Hepatobiliary Surgery, Dongyang People’s Hospital, No60,West Wuning Road, Dongyang, Jinhua, Zhejiang, China;Department of Internal Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, Taiwan;Department of Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, Taiwan

关键词: Endoscopic extraction;    Endoscopy;    Duodenorrhaphy;    Surgical complication;    Transmural migration;    Duodenal ulcer;    Gossypiboma;   

Others  :  863179
DOI  :  10.1186/1471-2482-14-36

 received in 2013-12-24, accepted in 2014-06-05,  发布年份 2014

【 摘 要 】

Background

Gossypiboma is a term used to describe a mass that forms around a cotton sponge or abdominal compress accidentally left in a patient during surgery. Transmural migration of an intra-abdominal gossypiboma has been reported to occur in the digestive tract, bladder, vagina and diaphragm. Open surgery is the most common approach in the treatment of gossypiboma. However, gossypibomas can be extracted by endoscopy while migrating into the digestive tract. We report a case of intractable duodenal ulcer caused by transmural migration of gossypiboma successfully treated by duodenorrhaphy. A systemic literature review is provided and a scheme of the therapeutic approach is proposed.

Case presentation

A 61-year-old Han Chinese man presented with intermittent epigastric pain for the last 10 months. He had undergone laparoscopic cholecystectomy conversion to open cholecystectomy for acute gangrenous cholecystitis 10 months ago at another hospital. Transmural migration of gossypiboma into the duodenum was found. Endoscopic intervention failed to remove the entire gauze, and duodenal ulcer caused by the gauze persisted. Surgical intervention was performed and the gauze was removed successfully. The penetrated ulcer was repaired with duodenorrhaphy. The postoperative period was uneventful.

We systematically reviewed the literature on transmural migration of gossypiboma into duodenum and present an overview of published cases. Our PubMed search yielded seven reports of transmural migration of retained surgical sponge into the duodenum. Surgical interventions were necessary in two patients.

Conclusion

Transmural migration of gossypiboma into the duodenum is a rare surgical complication. The treatment strategies include endoscopic extraction and surgical intervention. Prompt surgical intervention should be considered for emergent conditions such as active bleeding, gastrointestinal obstruction, or intra-abdominal sepsis. For non-emergent conditions, surgical intervention could be considered for intractable cases in which endoscopic extraction failed.

【 授权许可】

   
2014 Lv et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 5.

【 参考文献 】

• [1]Zantvoord Y, Weiden RM, van Hooff MH: Transmural migration of retained surgical sponges: a systemic review. Obstet Gynecol Surv 2008, 63(7):465-471.
• [2]Erdil A, Kilciler G, Ates Y, Tuzun A, Gulsen M, Karaeren N, Dagalp K: Transgastric migration of retained intraabdominal surgical sponge: gossypiboma in the bulbus. Inter Med 2008, 47(7):613-615.
• [3]Lin TY: Chuang CK:Gossypiboma: migration of retained surgical gauze and spontaneous transurethral protrusion. BJU Int 1999, 84(7):879-880.
• [4]Sinha SK, Udawat HP, Yadav TD, Lal A, Rana SS: Bhasin DK:Gossypiboma diagnosed by upper-GI endoscopy. Gastrointest Endosc 2007, 65:347-349.
• [5]Alis H, Soylu A, Dolay K, Kalacyci M, Ciltas A: Surgical intervention may not always be required in gossypiboma with intraluminal migration. World J Gastroenterol 2007, 13(48):6605-6607.
• [6]Peyrin-Biroulet L, Oliver A: Bigard MA:Gossypiboma successfully removed by upper-GI endoscopy. Gastrointest Endosc 2007, 66(6):1251-1252.
• [7]Dux M, Ganten M, Lubienski A, Grenacher L: Retained surgical sponge with migration into the duodenum and persistent duodenal fistula. Eur Radiol 2002, 12(suppl 3):S74-S77.
• [8]Manikyam SR, Gupta V, Gupta R, Gupta NM: Retained surgical sponge presenting as a gastric outlet obstruction and duodeno-ileo-colic fistula: report of a case. Surg Today 2002, 32:426-428.
• [9]Yildirim S, Tarim A, Nursal TZ, Yildirim T, Caliskan K, Torer N, Karagulle E, Noyan T, Noyan T, Moray G, Haberal M: Retained surgical sponge (gossypiboma) after intraabdominal or retroperitoneal surgery: 14 cases treated at a single center. Langenbecks Arch Surg 2006, 391(4):390-395.
• [10]Bani-Hani KE, Gharaibeh KA, Yaghan RJ: Retained surgical sponges(gossypiboma). Asian J Surg 2005, 28:109-115.
• [11]De Campos FF, Franco F, Maximiano LF, Martines JA, Felipe-silva AS, Kunitake TA: An iron deficiency anemia of unknown cause: a case report involving gossypiboma. Clinics (Sao Paulo) 2010, 65(5):555-558.
• [12]Akbulut S, Sevinc MM, Basak F, Aksory S, Cakabay B: Transmural migration of a surgical compress into the stomach after splenectomy: a case report. Cases J 2009, 2:7975.
• [13]Patil KK, Patil SK, Gorad KP, Panchal AH, Arora SS, Gautam RP: Intraluminal migration of surgical sponge: gossypiboma. Saudi J Gastroenterol 2010, 16(3):221-222.
• [14]Agarwal AK, Bhattacharya N, Mukherjee R: Intraluminal gossypiboma. Pak J Med Sci 2008, 24(3):461-463.
• [15]Cruz RJ Jr, Poli De Figueiredo LF, Guerra L: Intracolonic obstruction induced by a retained surgical sponge after trauma laparotomy. J Trauma 2003, 55(5):989-991.
• [16]Gupta S, Mathur AK: Spontaneous transmural migration of surgical sponge causing small intestine and large intestine obstruction. ANZ J Surg 2010, 80(10):756-757.
• [17]Govarjin HM, Talebian M, Fattahi F, Akbari ME: Migration of retained long gauze from abdominal cavity to intestine. JRMS 2010, 15(1):54-57.
• [18]Dakubo J, Clegg-Lamptey J, Hodasi W, Obaka H, Toboh H, Asempa W: An intra-abdominal gossypiboma. Ghana Med J 2009, 43(1):43-45.
• [19]Tiwary SKR, Khanna R, Khanna AK: Transmural Migration of Surgical Sponge Following Cholecystectomy: An unusual cause of gastric outlet obstruction. Internet J Surg 2006, 7:2.
• [20]Gwande AA, Studdert DM, Orav EJ, Brennan TA, Zinner MJ: Risk factors for retained instruments and sponges after surgery. N Engl J Med 2003, 348(3):229-235.
• [21]Mentes BB, Yilmaz E, Sen M, Kayhan B, Gorgul A, Tatlicioglu E: Transgastric migration of a surgical sponge. J Clin Gastroenterol 1997, 24(1):55-57.
• [22]Cheng TC, Chou AS, Jeng CM, Chang PY, Lee CC: Computed tomography findings of gossypiboma. J Chin Med Assoc 2007, 70(12):565-569.
• [23]Erbay G, Koc Z, Caliskan K, Araz F, Ulusan S: Imaging and clinical findings of a gossypiboma migrated into the stomach. Turk J Gastroenterol 2012, 23(1):54-57.
• [24]Kundan KK, Patil SK, Gorad KP: Intraluminal migration of surgical sponge: gossypiboma. Saudi J Gastroenterol 2010, 16(3):221-222.
• [25]Wattanasirichaigoon S: Transmural migration of a retained surgical sponge into the intestinal lumen: an experimental study. J Med Assoc Thai 1996, 79:415-422.
• [26]Sarda AK, Pandey D, Neogi S: Dhir U:Postoperative complications due to a retained surgical sponge. Singapore Med J 2007, 48:160-164.
• [27]Alegre-Salles V, Saba E, Dias-Soares P: Clinical images in gastroenterology: Textiloma (Gossypiboma) in the gastric lumen. Rev Gastroenterol Mex 2010, 75(1):77.
• [28]Keymeulen K, Dillemans B: Epitheloid angiosarcoma of the splenic capsula as a result of foreign body tumorigenesis. Case report Acta Chir Belg 2004, 104(2):217-220.
• [29]Sozutek A, Yormaz S, Kupeli H, Saban B: Transgastric migration of gossypiboma remedied with endoscopic removal: a case report. BMC Res Notes 2013, 14(6):413.
• [30]Kansakar R, Thapa P, Adhikari S: Intraluminal migration of gossypiboma without intestinal obstruction for fourteen years. JNMA J Nepal Med Assoc 2008, 47(171):136-138.
• [31]Yeung KW, Chang MS, Huang JF: Imaging of transmural migration of a retained surgical sponge: a case report. Kaohsiung J Med Sci 2004, 20(11):567-571.
• [32]Uluçay T, Dizdar MG, Sunay Yavuz M: The importance of medicolegal evaluation in a case with intra-abdominal gossypiboma. Forensic Sci Int 2010, 198(1–3):15-18.
• [33]Sumer A, Carparlar MA, Uslukaya O, Bayrak V, Kotan C, Kemik O, Llikerden U: Gossypiboma: retained surgical sponge after a gynecoogic procedure. Case Report Med 2010, 917626.
• [34]Sarker M, Kibra G, Haque M, Sarker KP: Spontaneous transmural migration of the retained surgical mop into the small intestinal lumen causing sub-acute intestinal obstruction: a case report. TAJ 2006, 19(1):34-37.
• [35]Turan M, Kibar Y, Karadayi K: Intraluminal migration of retained surgical sponge without sign of peritonitis — report of a case. Chir Gastroenterol 2003, 19(2):181-183.
• [36]Sharma D, Pratap A, Tandon A, Shukla RC, Shukla VK: Unconsidered cause of bowel obstruction- gossypiboma. Can J Surg 2008, 51(2):34-35.
• [37]Grassi N, Cipolla C, Torcivia A, Bottino A, Fiorentino E, Ficano L, Pantuso G: Trans-visceral migration of retained surgical gauze as a cause of intestinal obstruction: a case report. J Med Case Rep 2008, 2:17. BioMed Central Full Text
• [38]Gencosmanoglu R, Inceoglu R: An unusual cause of small bowel obstruction: gossypiboma— case report. BMC Surg 2003, 3:6. BioMed Central Full Text
• [39]Puri SK, Panicker H, Narang P: Spontaneous transmural migration of a retained surgical sponge into the intestinal lumen-a rare cause of Intestinal obstruction. Indian J Radiol Imag 2002, 12(1):137-139.
• [40]Silva CS, Caetano MR, Silva EA, Falco L, Murta EF: Complete migration of retained surgical sponge into ileum without sign of open intestinal wall. Arch Gynecol Obstet 2001, 265(2):103-104.
• [41]Disu S, Wijesiriwardana A, Mukhtar H, Eben F: An ileal migrationof a retained surgical swab (gossypiboma): a rare cause of an epigastric mass. J Obstet Gynaecol 2007, 27(2):212-213.
• [42]Kato T, Yamaguchi K, Kinoshita K, Sasaki K, Kagaya H, Meguro T, Morita T, Takahashi T: Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine. Case Rep Gastroenterol 2012, 6(3):754-759.
• [43]Malhotra MK: Migration surgical gossypiboma-cause of iatrogenic perforation: case report with review of literature. Niger J Surg 2012, 18(1):27-29.
• [44]Ogundiran T, Ayandipo O, Adeniji Sofoluwe A, Ogun G, Oyewole O, Ademola A: Gossypiboma: complete transmural migration of retained surgical sponge causing small bowel obstruction. BMJ Case Rep 2011. doi:10.1136/bcr.04.2011.4073
• [45]Rappaport W, Haynes K: The retained surgical sponge following intra-abdominal surgery. Continuing Problem Arch Surg 1990, 125(3):405-407.
• [46]Hinrichs C, Methratta S, Ybasco AC: Gossypiboma treated by colonoscopy. Pediatr Radiol 2003, 33(4):261-262.
• [47]Ozyer U, Boyvat F: Imaging of a retained laparotomy towel that migrated into the colon lumen. Indian J Radiol Imaging 2009, 19(3):219-221.
• [48]Choi JW, Lee CH, Kim KA, Park CM, Kim JY: Transmural migration of surgical sponge evacuated by defecation: mimicking an intraperitoneal gossypiboma. Korean J Radiol 2006, 7:212-214.
• [49]Reichelt A, Buchholz G, Schülke C: Migration of a retained intra-abdominal foreign body into the colon. Chirurg 2011, 82(11):1027-1030.
• [50]Tandon A, Bhargava SK, Gupta A, Bhatt S: Spontaneous transmural migration of retained surgical textile into both small and large bowel: a rare cause of intestinal obstruction. Br J Radiol 2009, 82(976):72-75.