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Tchangai B, Essobiyou TB, Ouedraogo SSL, Issa M, Keheou PA, Labou KA, Akakpo KL, Dosseh ED. Management of abdominal textilomas: A retrospective study. Int J Surg Case Rep 2024; 120:109816. [PMID: 38851066 PMCID: PMC11215090 DOI: 10.1016/j.ijscr.2024.109816] [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: 05/06/2024] [Accepted: 05/25/2024] [Indexed: 06/10/2024] Open
Abstract
INTRODUCTION Textilomas are an infrequent but well-known surgical complication. The authors report a series of cases to describe the frequency of abdominal textilomas, the circumstances in which they occur, their clinical and morphological characteristics, and their management, to contextualise these data, which may serve as a basis for preventive measures. SETTING AND METHOD This was a monocentric, retrospective, descriptive study conducted over 10 years at a tertiary hospital. The circumstances of the initial intervention, the diagnosis, and the treatment of textiloma cases treated in the said centre were documented. RESULTS Twenty-one (21) cases of abdominal textiloma were collected, with an annual frequency of 2.1 cases/year. The cases were predominantly female, with a female-to-male sex ratio of 1.62. The median age of the patients was 37 years. The initial operation was performed in a public facility in 80.95 % of cases. Myomectomy was the main indication (23.81 %). The time for signs to develop before consultation was 16.47 ± 8.82 days. Textiloma extraction was performed in an emergency in 61.90 % of cases. We noted morbidity (38.10 %) and mortality (9.52 %) in our patients. CONCLUSION Textilomas are a rare surgical complication, albeit with a high morbidity and mortality rate. Their clinical polymorphism and the difficulties of diagnosis and management mean that prevention is of prime importance.
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Ndiaye M, Cissé I, Faye PM, Gaye O, Diallo M, Fall PA. Gossypiboma migration into the bladder. Urol Case Rep 2024; 55:102769. [PMID: 38975050 PMCID: PMC11225654 DOI: 10.1016/j.eucr.2024.102769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/09/2024] [Accepted: 06/11/2024] [Indexed: 07/09/2024] Open
Abstract
Gossypiboma is a dreaded complication following mainly abdomino-pelvic surgeries. The clinical presentation varies widely and is strongly associated with two factors: localization of the textiloma and type of the tissue reaction. Intravesical gossypiboma migration is rare and usually presents as recurrent urinary tract infections. We report a case of gossypiboma migration into the bladder that was treated by endoscopic extraction. The purpose of this report is to remind the importance of the prevention which must be the challenge rather than the treatment modalities.
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Affiliation(s)
- Modou Ndiaye
- Department of Urology-Andrology, Cheikh Anta Diop University, Dakar, Senegal
| | - Ibrahima Cissé
- Department of Urology-Andrology, Cheikh Anta Diop University, Dakar, Senegal
| | - Papa Mamadou Faye
- Department of General Surgery, Cheikh Anta Diop University, Dakar, Senegal
| | - Oumar Gaye
- Department of Urology-Andrology, Cheikh Anta Diop University, Dakar, Senegal
| | - Mouhamed Diallo
- Department of Urology-Andrology, Cheikh Anta Diop University, Dakar, Senegal
| | - Papa Ahmed Fall
- Department of Urology-Andrology, Cheikh Anta Diop University, Dakar, Senegal
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The Benign Side of the Abdominal Wall: A Pictorial Review of Non-Neoplastic Diseases. Diagnostics (Basel) 2022; 12:diagnostics12123211. [PMID: 36553218 PMCID: PMC9778078 DOI: 10.3390/diagnostics12123211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The abdominal wall is the location of a wide spectrum of pathological conditions, from benign to malignant ones. Imaging is often recommended for the evaluation of known palpable abdominal masses. However, abdominal wall pathologies are often incidentally discovered and represent a clinical and diagnostic challenge. Knowledge of the possible etiologies and complications, combined with clinical history and laboratory findings, is crucial for the correct management of these conditions. Specific imaging clues can help the radiologist narrow the differential diagnosis and distinguish between malignant and benign processes. In this pictorial review, we will focus on the non-neoplastic benign masses and processes that can be encountered on the abdominal wall on cross-sectional imaging, with a particular focus on their management. Distinctive sonographic imaging clues, compared with computed tomography (CT) and magnetic resonance (MR) findings will be highlighted, together with clinical and practical tips for reaching the diagnosis and guiding patient management, to provide a complete diagnostic guide for the radiologist.
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Ranjan P, Jha V, Nair V, Eranki S, Singh O. Clinical Spectrum of Gossypiboma: Case Series and Review of Literature. JOURNAL OF MARINE MEDICAL SOCIETY 2022. [DOI: 10.4103/jmms.jmms_75_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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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.
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Affiliation(s)
- Hilmi Bozkurt
- Haseki Research and Education Hospital, Istanbul, Turkey
| | - Betül Öğüt
- Pathology Department, Gazi University Faculty of Medicine, Ankara, Turkey
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Intra-abdominal Gossypibomas: Clinical Manifestations, Risk Factors and Prevention. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02511-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Takeda A, Shinone S, Nakamura H. Laparoendoscopic Single-Site Surgery for Management of Gossypiboma Masquerading as an Adnexal Mass. J Gynecol Surg 2020. [DOI: 10.1089/gyn.2019.0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Akihiro Takeda
- Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - Sanae Shinone
- Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - Hiromi Nakamura
- Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
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Tchangai B, Tchaou M, Kassegne I, Simlawo K. Incidence, root cause, and outcomes of unintentionally retained intraabdominal surgical sponges: a retrospective case series from two hospitals in Togo. Patient Saf Surg 2017; 11:25. [PMID: 29090018 PMCID: PMC5657063 DOI: 10.1186/s13037-017-0140-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 10/13/2017] [Indexed: 12/23/2022] Open
Abstract
Background The term gossypiboma refers to a sponge that has been forgotten in the surgical field. It is the most common retained surgical item, and constitutes a continuing problem for surgical safety. We performed a hospital-based study to examine their incidence, root cause, and outcomes, as an effort toward improving prevention. Methods This retrospective study covered 10 years (2006-2015) and included surgically confirmed cases of abdominal gossypibomas occurring after 45,011 abdominal and gynaecological operations in 2 public hospitals in Lome (Togo). Age, diagnosis, initial surgical procedure, evidence of textile count, and data related to the revision procedure were collected for descriptive analysis. Results Fifteen cases of gossypibomas (11 women and 4 men) were recorded. The mean age of the patients was 27 (range 21-55) years. Initial procedures were gynaecological in 11 patients and 5 cases involved an emergency surgery. Evidence of sponge counting was found in 6cases. Gossypiboma was an incidental finding in 1 patient. The average time to onset of symptoms after the initial procedure was 2 months. The gossypiboma was removed within 7 days to 4 years after the initial procedure. Postoperative complications included enterocutaneous fistula in 2 patients, incisional hernia in 2 patients, and wound sepsis in 1 patient. Death occurred in 2 patients (13.3%). Conclusions Although rare, the incidence of gossypibomas is still unacceptably high and reveals failures regarding patient safety standards. The associated morbidity and mortality are significant, yet can be reduced by an early diagnosis in the immediate postoperative period. A systematic methodical count of sponges is the cornerstone of prevention, and introducing surgical safety protocols, such as the WHO Safe Surgery Saves Lives checklist, can enhance effectiveness. There is a crucial need for safety-focused policies, which may include a never event reporting system, elaboration of prevention strategies, interventions, and evaluation.
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Affiliation(s)
- Boyodi Tchangai
- Department of Surgery, Teaching Hospital of Sylvanus Olympio, Lomé, Togo.,Visceral surgeon at Sylvanus Olympio Teaching Hospital, 198 rue de la santé, P.O Box 57, Lomé, Togo
| | - Mazamaesso Tchaou
- Department of Radiology, Teaching Hospital of Sylvanus Olympio, Lomé, Togo
| | - Iroukora Kassegne
- Department of Surgery, Teaching Hospital of Sylvanus Olympio, Lomé, Togo
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Unruh K, Hsieh HSS. Gossypiboma Resection after Eight Years in a Patient with Rheumatoid Arthritis and Diabetes. Case Rep Surg 2017; 2017:3239093. [PMID: 29109890 PMCID: PMC5646340 DOI: 10.1155/2017/3239093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/29/2017] [Indexed: 11/17/2022] Open
Abstract
Gossypiboma is the term used to refer to a mass formed by surgical material left in the body cavity after surgery. We present the case of a middle-aged woman with a history of rheumatoid arthritis controlled with corticosteroids and biologic therapies, uncontrolled type II diabetes mellitus, and cesarean section with postoperative bleeding eight years earlier, who presents with right lower quadrant abdominal pain and is found to have a gossypiboma from her previous operation. A subsequent operation is undertaken to remove the gossypiboma. After the procedure, our patient's diabetes and chronic back pain greatly improve, raising the question of gossypiboma's role in these diseases. A review of our patient's records found that a correct sponge count was recorded after her cesarean section, raising questions about the operating room policies regarding surgical counts, the presence of falsely correct counts, and the need for postoperative plain films in procedures with an increased risk of a retained object. Our patient's presentation eight years after the inciting surgery raises questions about the involvement her immunosuppressive therapy may have had in cloaking the gossypiboma. Our case also raises the question of surgical culpability, including the ethical and legal considerations for apology from the culpable surgeon.
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Affiliation(s)
- Kenley Unruh
- University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA
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Zhang H, Jiang Y, Wang Q, Liu J. Lower abdominal gossypiboma mimics ovarian teratoma: a case report and review of the literature. World J Surg Oncol 2017; 15:6. [PMID: 28061867 PMCID: PMC5217399 DOI: 10.1186/s12957-016-1082-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 12/22/2016] [Indexed: 11/16/2022] Open
Abstract
Background Gossypiboma is a serious and potentially dangerous medico-legal problem. Case presentation We present a case of lower abdominal gossypiboma that presented as an abdominal cystic mass mimicking ovarian teratoma. The mass and the adhesive intestine loop were en blocly resected. The cut section confirmed gossypiboma diagnosis. Conclusions The present experience and related literature results indicate that gossypiboma should always be kept in mind for the differential diagnosis of cystic soft-tissue mass detected in patients with a prior operation history despite its rarity and diagnosis difficulty. Once detected or suspected, appropriate surgical intervention should be performed promptly. Most importantly, preventing is much more crucial than curing in order to avoid this highly undesired potential complication.
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Affiliation(s)
- Hao Zhang
- Department of General Surgery, The First Hospital of Jiaxing, Jiaxing, Zhejiang, 314001, China.
| | - Yanyong Jiang
- Department of General Surgery, Puding County People's Hospital, Anshun, Guizhou, 562100, China
| | - Qingqing Wang
- Department of General Surgery, The First Hospital of Jiaxing, Jiaxing, Zhejiang, 314001, China
| | - Jun Liu
- Department of General Surgery, The First Hospital of Jiaxing, Jiaxing, Zhejiang, 314001, China
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