Intraluminal migration of retained surgical sponge as a cause of intestinal obstruction

Gossypiboma, the Hidden Enemy of an Emergency Cesarean Hysterectomy-Case Report and Review of the Literature

Gossypiboma or textiloma is a rare medical situation that can complicate the favorable evolution of a surgical case, with repercussions for the patient's prognosis. The diagnosis can be difficult due to various clinical symptoms, the time elapsed since the surgical intervention, and the imaging often not being precise in detecting textilomas. Due to the medicolegal implications, the reporting of this event is inconsistent. We present a rare case of a 28-year-old woman who presented with vague pain in the left iliac fossa 11 months after an emergency cesarean hysterectomy was performed. The preoperative imaging examination identified the presence of a subhepatic mass with dimensions of 10 × 8 cm2 and another formation in the right iliac fossa with dimensions of 11 × 9 cm2. Exploratory laparotomy found the presence of a large subhepatic gossypiboma, intimately adherent to the hepatic angle of the colon and omentum and a second one adherent to the sigmoid colon, small intestine, and parietal peritoneum. The particularity of this case is given by the simultaneous presence of two textilomas with inconclusive evolution, which can make the differential diagnosis difficult to achieve. For a better assessment of the risk of occurrence of this pathology and the identification of a correct prevention strategy, we performed an extensive search and a review of all the articles published in the PubMed database, identifying 57 articles. In conclusion, emergency surgery increases the risk of this complication, and, as a result, prevention can be achieved by following existing protocols in the operating room.

Endoscopic removal of a transgastric migrated textiloma: a case report

Aim: Abdominal textiloma is an uncommon postoperative complication which can result in a fistula with luminal migration in the digestive tract. Surgery has been the mainstay method for textiloma removal; however, removal of retained gauze by upper gastrointestinal endoscopy is possible avoiding reoperation. Case report: We report a case of an abdominal textiloma in a 38-year-old male, which migrated into the stomach and was extracted by upper endoscopy. Conclusion: Endoscopic extraction after a luminal migration of the abdominal textiloma in the digestive tract facilitate its management and could avoid surgery.