An unusual cause of small bowel obstruction: Gossypiboma – case report

BMC Surgery

Resit Inceoglu²  Rasim Gencosmanoglu¹ 

[1] Department of Gastrointestinal Surgery, Marmara University Institute of Gastroenterology, Istanbul, Turkey;Department of General Surgery, Marmara University School of Medicine, Istanbul, Turkey

关键词: CT;    radiography;    intestinal obstruction;    retained surgical towel;    foreign bodies;    gossypiboma;   

Others  :  1123812
DOI  :  10.1186/1471-2482-3-6

 received in 2003-04-30, accepted in 2003-09-08,  发布年份 2003

【 摘 要 】

Background

The term "gossypiboma" denotes a mass of cotton that is retained in the body following surgery. Gossypiboma is a medico-legal problem especially for surgeons. To the best of our knowledge, the patient presented herein is the second reported patient in whom the exact site of migration of a retained surgical textile material into the intestinal lumen could be demonstrated by preoperative imaging studies.

Case presentation

A 74-year-old woman presented with symptoms of small bowel obstruction due to incomplete intraluminal migration of a laparotomy towel 3 years after open cholecystectomy and umbilical hernia repair. Plain abdominal radiography did not show any sign of a radio-opaque marker in the abdomen. However, contrast enhanced abdominal computerized tomography revealed a round, well-defined soft-tissue mass with a dense, enhanced wall, containing an internal high-density area with air-bubbles in the mid-abdomen. A fistula between the abscess cavity containing the suspicious mass and gastrointestinal tract was identified by upper gastrointestinal series. The presence of a foreign body was considered. It was surgically removed with a partial small bowel resection followed by anastomosis.

Conclusions

Although gossypiboma is rarely seen in daily clinical practice, it should be considered in the differential diagnosis of acute mechanical intestinal obstruction in patients who underwent laparotomy previously. The best approach in the prevention of this condition can be achieved by meticulous count of surgical materials in addition to thorough exploration of surgical site at the conclusion of operations and also by routine use of surgical textile materials impregnated with a radio-opaque marker.

【 授权许可】

   
2003 Gencosmanoglu and Inceoglu; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

【 图 表 】

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