1
|
Bourabaa S, El Hamdani H, Hamid M, Zhim M, Settaf A. Gossypiboma mimicking a hydatid cyst: A case report. Int J Surg Case Rep 2023; 113:109034. [PMID: 37980773 PMCID: PMC10694283 DOI: 10.1016/j.ijscr.2023.109034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/21/2023] Open
Abstract
INTRODUCTION Retained foreign bodies have become very rare in countries where the safety rules in the operating theater are very rigorous and follow precise guidelines. Maintaining awareness of this issue among surgeons and radiologists is of paramount importance to minimize avoidable morbidity and facilitate the selection of the most suitable therapeutic strategy. This consideration is particularly relevant in the differential diagnosis of hydatid cysts. This study describes a case of intra-abdominal gossypiboma, which mimicked hydatid cyst on preoperative assessment. CASE PRESENTATION We report the case of a 63-year-old female who was referred to our department for the management of a hepatic hydatid cyst. She has history of open cholecystectomy and oophorocystectomy. During the intervention, we discovered a 10 cm mass located in the interhepatogastric region. Complete resection of the mass was performed, and pathology results were compatible with a piece of gauze surrounded by reactive changes (gossypiboma). DISCUSSION Gossypiboma is undeniably a source of concern for surgeons. It's a genuine and serious surgical complication which can potentially arise from any type of surgery and may manifest with diverse complaints. However, it is crucial to emphasize that this complication is preventable with the primary preventive measure being meticulous counting of surgical materials during the procedure. CONCLUSION The potential embarrassment experienced by the surgeon and the significant legal consequences associated with this iatrogenic complication are substantial. Hence, it becomes imperative to adopt all requisite preventive measures to avert such incidents, as there is no excuse that can justify their occurrence.
Collapse
Affiliation(s)
- S Bourabaa
- Surgical Department B, Ibn Sina University Hospital, Rabat, Morocco; Université Mohamed V of Rabat, Rabat, Morocco.
| | - H El Hamdani
- Surgical Department B, Ibn Sina University Hospital, Rabat, Morocco; Université Mohamed V of Rabat, Rabat, Morocco
| | - M Hamid
- Surgical Department B, Ibn Sina University Hospital, Rabat, Morocco; Université Mohamed V of Rabat, Rabat, Morocco
| | - M Zhim
- Radiology Department, Ibn Sina University Hospital, Rabat, Morocco; Université Mohamed V of Rabat, Rabat, Morocco
| | - A Settaf
- Surgical Department B, Ibn Sina University Hospital, Rabat, Morocco; Université Mohamed V of Rabat, Rabat, Morocco
| |
Collapse
|
2
|
Bozkurt H, Öğüt B. A gossypiboma masquerading as a mesenteric cyst. Malawi Med J 2021; 33:68-70. [PMID: 34422237 PMCID: PMC8360287 DOI: 10.4314/mmj.v33i1.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Gossypiboma refers to foreign bodies left inside the body during surgery, such as sponges and gauze. These foreign bodies represent a significant cause of morbidity and mortality. A 57-year-old female presented to us with right upper abdominal pain. Her past history was non-contributory except for an open cholecystectomy 20 years previously. A physical examination revealed tenderness to palpation on the right of the abdomen, while the remaining examination was normal. An abdominal computed tomography (CT) and magnetic resonance imaging (MRI) scan revealed a well-defined calcified mass of 5 cm that was compatible with a mesenteric cyst. During surgery, the mass was found to be adherent to the mesocolon and to have invaded the colon wall. A right hemicolectomy and ileotransverse anastomosis was performed. The pathological mass was considered to be a gossypiboma that had been left behind during the earlier cholecystectomy. The body's reaction to the foreign body was seen to extend beyond the lamina propria and muscularis propria. Gossypiboma is an undesired and life-threatening but preventable surgical complication. This condition may present with non-specific findings and a clinical scenario that mimics various disorders, even after many years. A diagnosis of gossypiboma should be kept in mind for patients with a history of previous operations and undergoing surgery due to the suspicion of a mesenteric cyst.
Collapse
Affiliation(s)
- Hilmi Bozkurt
- Haseki Research and Education Hospital, Istanbul, Turkey
| | - Betül Öğüt
- Pathology Department, Gazi University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
3
|
Kanat BH, Kutluer N, Bozan MB, Aksoy N, Öztürk T. A FORGOTTEN STATUS: GOSSYPIBOMA. ACTA ACUST UNITED AC 2021; 34:e1571. [PMID: 34008712 PMCID: PMC8121046 DOI: 10.1590/0102-672020190004e1571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/21/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Burhan Hakan Kanat
- University of Health Sciences, Elazığ City Hospital, Department of General Surgery, Elazig/Turkey
| | - Nizamettin Kutluer
- University of Health Sciences, Elazığ City Hospital, Department of General Surgery, Elazig/Turkey
| | - Mehmet Buğra Bozan
- Medical Faculty of Kahramanmaras Sutcu Imam University, Department of General Surgery, Kahramanmaras/Turkey
| | - Nurullah Aksoy
- Siverek State Hospital, Department of General Surgery, Şanlıurfa/Turkey
| | - Tülin Öztürk
- University of Health Sciences, Elazığ City Hospital, Department of Radiology, Elazig/Turkey
| |
Collapse
|
4
|
Bozkırlı BO, Gündoğdu RH, Ersoy PE, Akbaba S, Oduncu M. Gossypiboma mistaken for a hydatid cyst: case report. Turk J Surg 2020; 36:405-408. [PMID: 33778401 DOI: 10.47717/turkjsurg.2020.3742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 01/31/2017] [Indexed: 11/23/2022]
Abstract
Although considered a rare complication, gossypiboma continues to be a clinically important and probably more frequently encountered than reported situation. This study aimed to report a case of gossypiboma that was mistaken for a hydatid cyst in the preoperative evaluation. A 34-year-old male patient with a history of Nissen Fundoplication presented with a large mass palpable in the epigastrium and both the left upper and lower quadrants of the abdomen. Computerized tomography was reported to show a 20x18 cm cystic mass with a collapsed germinative membrane inside it. Laparotomy, which was performed with a suggested diagnosis of type 3 hydatid cyst, revealed that the mass was caused by a 30x30 cm surgical abdominal compress. We believe gossypiboma should be kept in mind in the differential diagnosis of abdominal hydatid cysts in the presence of a former abdominal operation, especially when the result of indirect hemagglutination test is negative.
Collapse
Affiliation(s)
| | - Rıza Haldun Gündoğdu
- Clinic of General Surgery, Atatürk Training and Research Hospital, Ankara, Turkey
| | | | - Soner Akbaba
- Clinic of General Surgery, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Mehmet Oduncu
- Clinic of General Surgery, Samandağ Güneypark Hospital, Hatay, Turkey
| |
Collapse
|
5
|
de Sousa JB, Alves Martins BA, Rocha Ferreira IA, E Silva SM, de Oliveira PG. Transmural Migration of Gossypiboma with Intraluminal Small-Bowel Obstruction: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e924506. [PMID: 32817594 PMCID: PMC7458695 DOI: 10.12659/ajcr.924506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patient: Female, 26-year-old Final Diagnosis: Gossypiboma Symptoms: Abdominal pain Medication:— Clinical Procedure: — Specialty: Surgery
Collapse
Affiliation(s)
| | | | | | - Silvana Marques E Silva
- Unit of Coloproctology, Federal District Strategic Health Management Institute (Instituto de Gestão Estratégica de Saúde do Distrito Federal (IGESDF)), Brasília, Brazil
| | | |
Collapse
|
6
|
Khanijaun SS, Pang TCY. Cystic lesion in the left upper quadrant. ANZ J Surg 2018; 89:E531-E532. [PMID: 30239103 DOI: 10.1111/ans.14858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 08/02/2018] [Accepted: 08/15/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Sukhwant S Khanijaun
- Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Tony C Y Pang
- Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
7
|
Rabie ME, Hosni MH, Al Safty A, Al Jarallah M, Ghaleb FH. Gossypiboma revisited: A never ending issue. Int J Surg Case Rep 2015; 19:87-91. [PMID: 26741272 PMCID: PMC4756180 DOI: 10.1016/j.ijscr.2015.12.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 12/17/2015] [Indexed: 11/12/2022] Open
Abstract
Retained foreign objects (RFO), is one of the most dreadful complications of surgery. Despite a seemingly correct count, laparotomy pads were missed at the end of surgery in three patients. Human errors continue to occur and RFO continues to plague the surgical practice. To avoid human error, one of several recent technologies designed to check for items left behind, should be employed. In our report, we give an important tip on how to extract the retained surgical sponge without causing much damage.
Introduction Leaving a surgical item inside the patient at the end of surgery, is one of the most dreadful complications. The item is frequently a surgical sponge and the resultant morbidity is usually severe. Additionally, the event poses considerable psychic strain to the operating team, notably the surgeon. Presentation of cases Here we describe the clinical course of three patients in whom a surgical sponge was missed, despite a seemingly correct count at the end of difficult caesarean sections. In two patients, who presented shortly after surgery, the pad was extracted with no bowel resection. In the third patient, who presented several years after surgery, colectomy was performed. Discussion Gossypiboma is under reported and the true incidence is largely unknown. Depending on the body reaction and the characters of the retained sponge, the patient may present within months to years after surgery. Risk factors for retained foreign objects include emergency surgery, an unplanned change in the surgical procedure, higher body mass index, multiple surgical teams, greater number of major procedures done at the same time and incorrect count recording. The surgical procedure needed to extract the retained sponge may be a simple one, as in the first case, or it may be more complex, as seen in the other two cases. Although holding the correct count at the end of surgery is the gold standard safeguard against this mishap, human errors continue to occur, as happened in our patients. For that reason, the correct count should be supplemented by employing one of the several new technologies currently available. Conclusion Gossypiboma continues to occur, despite precautionary measures. As its consequences might cost the patient his life and the surgeon his professional reputation, extra preventive measures should be sought and implemented. New advances in technology should be incorporated in the theatre protocol as additional safeguard against human error. When encountered, a direct incision over the encapsulated swelling, in contrast to a formal laparotomy incision, might simplify the surgical procedure.
Collapse
Affiliation(s)
- M Ezzedien Rabie
- Department of Surgery, Aseer Central Hospital-Abha, Saudi Arabia.
| | | | - Alaa Al Safty
- Department of Surgery, Aseer Central Hospital-Abha, Saudi Arabia
| | | | | |
Collapse
|
8
|
Sozutek A, Colak T, Reyhan E, Turkmenoglu O, Akpınar E. Intra-abdominal Gossypiboma Revisited: Various Clinical Presentations and Treatments of this Potential Complication. Indian J Surg 2015; 77:1295-300. [PMID: 27011554 DOI: 10.1007/s12262-015-1280-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 05/11/2015] [Indexed: 10/23/2022] Open
Abstract
Gossypiboma is the term used to describe a retained non-absorbable surgical material that is composed of cotton matrix which leads to serious surgical complications for both patient and surgeon. Its incidence is not precisely known probably due to medico-legal importance of this potential complication. The condition may manifest either as asymptomatic or severe gastrointestinal complications. The increasing number of recent reports in the literature implies that this issue still remains as an important problem to be solved after intra-abdominal surgery. In this report, we aimed to emphasize this potential complication by presenting the clinical outcomes of our 14 patients who underwent different surgical interventions for gossypiboma. Between February 2009 and October 2014, a total of 14 patients who underwent surgery for gossypiboma were reviewed retrospectively. The patients were analyzed with regard to demographic characteristics, initial diagnosis-prior surgery, clinical presentation, the interval period from the first operation to last definite operation, diagnostic methods, gossypiboma location, definite surgery, and postoperative outcomes. A total of 14 patients including 6 (42.9 %) male and 8 (57.1 %) female with a median age of 41.4 ± 12 years (22-61 years) enrolled in this study. The prior surgery of 10 (71.4 %) patients was performed by general surgeons, while 4 (28.6 %) patients were operated by gynecologists. The interval period from prior surgery to definite surgery ranged from 14 days to 113 months. Three (21.4 %) patients were asymptomatic, whereas the vast of the patients were complicated (fistula, ileus, wound infection). Gossypiboma was removed by open surgery, laparoscopic surgery, and endoscopic intervention in 10, 2, and 1 patient, respectively. Removal was performed from perineal wound side in one patient. Removal was enough for definitive treatment in 10 (71.4 %) patients whereas bowel resection and primary repair was performed in 4 (28.6 %) patients due to fistula or perforation. One patient died from intra-abdominal sepsis on postoperative 13th day. Gossypiboma should strongly be considered in differential diagnosis of any postoperative patient with mild gastrointestinal symptom or with persistent wound infection. Adequate surgical intervention should be planned as soon as possible either to prevent further complications or to overcome medico-legal problems, when gossypiboma is detected.
Collapse
Affiliation(s)
- Alper Sozutek
- Department of Gastroenterological Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Tahsin Colak
- Department of General Surgery, Mersin University Medical Faculty, Mersin, Turkey
| | - Enver Reyhan
- Department of Gastroenterological Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Ozgur Turkmenoglu
- Department of General Surgery, Mersin University Medical Faculty, Mersin, Turkey
| | - Edip Akpınar
- Department of Gastroenterological Surgery, Adana Numune Training and Research Hospital, Adana, Turkey
| |
Collapse
|
9
|
Yagmur Y, Akbulut S, Gumus S. Post cholecystectomy gossypiboma mimicking a liver hydatid cyst: comprehensive literature review. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e22001. [PMID: 26023336 PMCID: PMC4443399 DOI: 10.5812/ircmj.17(4)2015.22001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 09/25/2014] [Accepted: 03/25/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gossypiboma is the term for forgotten textile products such as a surgical sponge and compress in the body cavity after a surgical procedure. OBJECTIVES The aim of this study was to evaluate previously published articles related to post cholecystectomy gossypiboma. MATERIALS AND METHODS We conducted a systematic search using PubMed, Medline, Google and Google Scholar on post cholecystectomy gossypiboma. The keywords used were: gossypiboma and cholecystectomy, textiloma and cholecystectomy and post cholecystectomy gossypiboma. Furthermore, we also present a new case of post cholecystectomy gossypiboma. RESULTS A total of 32 articles concerning 38 patients with post cholecystectomy gossypiboma that met the aforementioned criteria were included. Detailed intraoperative findings and surgical management were provided. The patients were aged from 26 to 79 years (Mean ± SD: 47 ± 13.6 years); 32 were female and six were male. The time from the causative operation to presentation with a retained surgical sponge ranged from one to 480 months (Mean ± SD: 56.5 ± 93.5 months). CONCLUSIONS Gossypiboma may not be symptomatic for many years or could be symptomatic for a short duration of time. Besides being a rare surgical complication, gossypiboma can lead to serious morbidity and mortality that may cause medico-legal problems. Diagnosis with imaging methods is difficult.
Collapse
Affiliation(s)
- Yusuf Yagmur
- Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey
| | - Sami Akbulut
- Department of Surgery, Liver Transplantation Institute, Faculty of Medicine, Inonu University, Malatya, Turkey
- Corresponding Author: Sami Akbulut, Department of Surgery, Liver Transplantation Institute, Faculty of Medicine, Inonu University, P. O. Box: 44280, Malatya, Turkey. Tel: +90-4223410660, Fax: +90-4223410036, E-mail:
| | - Serdar Gumus
- Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey
| |
Collapse
|
10
|
Silva SME, Sousa JBD. [Gossypiboma after abdominal surgery is a challenging clinical problem and a serious medicolegal issue]. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2014; 26:140-3. [PMID: 24000029 DOI: 10.1590/s0102-67202013000200015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 11/27/2012] [Indexed: 11/15/2023]
Abstract
INTRODUCTION The term "gossypiboma" refers to a textile matrix surrounded by foreign body reaction. Gauze and surgical dressings are the most commonly retained materials after laparotomy. AIM To evaluate the incidence of abdominal gossypiboma, its causes and the preventive measures to reduce the frequence and morbimortality. METHOD Was conducted a literature review in Medline/Pubmed in english. The survey was about the last 10 years, selecting the headings: gossypiboma, textiloma, retained foreign body and abdominal surgery. Thirty articles were considered in this review. RESULTS The incidence of gossypiboma is underreported, mostly due to the legal implications of their detection but also because many patients remain asymptomatic. Occur in 1/1000 to 1/1500 of intra-abdominal operations. Clinical presentation is variable, and depends on the location of the foreign body and on the type of inflammatory reaction presented by the host. The recommended course of treatment is excision, which can be accomplished endoscopically, laparoscopically, or via the open route, and seeks to prevent the complications that lead to a high mortality rate. The most important approach is prevention. Preventive measures required include exploration of the abdominal cavity at the end of the procedure, use of textiles with radiopaque markers and a meticulous account of surgical materials. CONCLUSION Gossypiboma is a former medical-legal problem, whose incidence is apparently increasing. Therefore needs to be revised to take preventive measures in the operating room.
Collapse
|
11
|
Extrahepatic textiloma long misdiagnosed as calcified echinococcal cyst. Case Rep Gastrointest Med 2013; 2013:261685. [PMID: 23533840 PMCID: PMC3600324 DOI: 10.1155/2013/261685] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 01/29/2013] [Indexed: 12/28/2022] Open
Abstract
Textiloma or gossypiboma is a retained surgical swab in the body after an operation and is a complication that can remain undetected for many years and may represent a diagnostic dilemma depending on its location. It may be confused with several focal lesions and an accurate history taking, combined with clinical and instrumental data, is key to suspecting the diagnosis. We report a case of abdominal textiloma that was initially misdiagnosed as echinococcal cyst and discuss the differential diagnosis based on sonographic features and the WHO-IWGE classification.
Collapse
|
12
|
Nemati MH. Mediastinal gossypiboma simulating a malignant tumour. Interact Cardiovasc Thorac Surg 2012; 15:783-5. [PMID: 22786789 DOI: 10.1093/icvts/ivs260] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Gossypiboma or textiloma are two terms used to describe any cotton matrix such as gauze pads left behind during an operation in the body cavities. They may lead to infections or abscess formations, or may mimic malignant tumours. Here, we present a woman with a history of a previous operation on her thorax who became symptomatic 25 years after the operation because of retained surgical gauzes covered by fibrinous materials with adhesions to the left lung. The cotton matrix had developed into a gossypiboma mimicking a mediastinal tumour.
Collapse
Affiliation(s)
- Mohammad Hassan Nemati
- Department of Cardiac Surgery, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
13
|
Malhotra MK. Migratory surgical gossypiboma-cause of iatrogenic perforation: case report with review of literature. Niger J Surg 2012; 18:27-9. [PMID: 24027390 PMCID: PMC3716248 DOI: 10.4103/1117-6806.95486] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Forgotten foreign bodies, such as cotton sponges, gauze, or instruments, after any surgical procedure is considered a misadventure but avoidable complication. “Gossypiboma” denotes a mass of cotton that is accidentally retained in the body postoperatively. This study’s goal was to systematically review the literature on retained sponges to identify incidence, site of occurrence, time of discovery, methods for detection, pathogenesis for intraluminal migration and risk factors. Author is reporting this case in which a 45-year old woman presented with features of chronic pain abdomen following abdominal hysterectomy (first surgery) which lead to open cholecystectomy (second surgery) after two and half year of first surgery. As patients continued to have persistent abdominal pain in spite of second surgery patient went to medical gastroenterologist who advised her series of tests including colonoscopy examination. The whole colon was normal on examination but on examination of terminal portion of small bowel some intraluminal mass was visualized. Attempt to retrieve this mass lead to iatrogenic ileal perforation.
Collapse
Affiliation(s)
- Mohinder Kumar Malhotra
- Department of General Surgery, SGT Medical College, Hospital and Research Institute, Gurgaon, India
| |
Collapse
|