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Jidal M, Horache K, Achemlal A, Saouab R, El Fenni J. Transgastric migration of retained intraabdominal surgical sponge: Gossypiboma in the fundus. Radiol Case Rep 2024; 19:2452-2456. [PMID: 38585404 PMCID: PMC10997863 DOI: 10.1016/j.radcr.2024.02.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 04/09/2024] Open
Abstract
The retention of a surgical sponge is a rare complication that presents diagnostic challenges and carries the risk of potential complications. Two distinct foreign body reactions, fibrinous, and exudative, can result in the formation of a granuloma (known as gossypiboma) or lead to complications such as abscess formation and migration into the gastrointestinal tract. In this report, we present the case of a 33-year-old woman with a history of splenectomy who presented with symptoms including epigastric pain, vomiting, and episodes of hematemesis. Imaging studies, including computed tomography and magnetic resonance imaging, revealed a mass consistent with a gossypiboma that had migrated transmurally into the stomach. The diagnosis was subsequently confirmed through gastroscopy, and successful endoscopic removal of the retained surgical sponge was performed.
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Affiliation(s)
- Manal Jidal
- Radiology department, Mohammed V military hospital of Rabat, Rabat, Morocco
| | - Kenza Horache
- Radiology department, Mohammed V military hospital of Rabat, Rabat, Morocco
| | - Amine Achemlal
- Gastroenterology department, Mohammed V military hospital of Rabat, Rabat, Morocco
| | - Rachida Saouab
- Radiology department, Mohammed V military hospital of Rabat, Rabat, Morocco
| | - Jamal El Fenni
- Radiology department, Mohammed V military hospital of Rabat, Rabat, Morocco
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2
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Achemlal A, Nejjari F, Jidal M, Taibi O, Berrag S, Adioui T, Tamzaourte M. Endoscopic management of a transgastric migrated gossypiboma: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241248379. [PMID: 38659655 PMCID: PMC11041531 DOI: 10.1177/2050313x241248379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
Textiloma, also known as gossypiboma, is a rare but well-documented entity. It involves the omission of surgical material during surgery. Gossypiboma remains a diagnostic dilemma to this day, due to its wide spectrum of clinical symptoms and numerous radiological pitfalls. The recommended treatment for gossypiboma is surgical removal. Endoscopic removal has been performed by some teams and has shown satisfying results. We report the case of a 33-year-old woman with a transgastric migrating gossypiboma, managed by an endoscopic extraction.
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Affiliation(s)
- Amine Achemlal
- Department of Gastroenterology 1, Mohammed V Military Training Hospital, Rabat, Morocco
| | - Fouad Nejjari
- Department of Gastroenterology 1, Mohammed V Military Training Hospital, Rabat, Morocco
| | - Manal Jidal
- Department of Radiology, Mohammed V Military Training Hospital, Rabat, Morocco
| | - Ouiam Taibi
- Department of Radiology, Mohammed V Military Training Hospital, Rabat, Morocco
| | - Sanaa Berrag
- Department of Gastroenterology 1, Mohammed V Military Training Hospital, Rabat, Morocco
| | - Tarik Adioui
- Department of Gastroenterology 1, Mohammed V Military Training Hospital, Rabat, Morocco
| | - Mouna Tamzaourte
- Department of Gastroenterology 1, Mohammed V Military Training Hospital, Rabat, Morocco
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El Omri G, Rais H, Rachid M, Guennouni M, Heddat A. Intravesical Textiloma: A Rare Complication Following Laparoscopic Inguinal Hernia Repair - A Case report. Clin Med Insights Case Rep 2023; 16:11795476231219073. [PMID: 38106618 PMCID: PMC10725085 DOI: 10.1177/11795476231219073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/21/2023] [Indexed: 12/19/2023]
Abstract
Introduction Today, surgical errors are becoming less and less frequent, thanks to the development of new techniques and the choice of different approaches. Nevertheless, they are still possible, and it is important to mention them in order to prevent them and avoid their recurrence. Case Presentation We report a case of intravesical textiloma, rarely observed in urological surgery, in an 80-year-old patient who underwent laparoscopic inguinal hernia repair and presented to a urological consultation with hematuria and irritative lower urinary tract signs. Abdominal ultrasound revealed a hyperechoic tissue-like formation in the posterior wall of the bladder. The diagnosis of a bladder tumor was therefore raised, and cystoscopy was performed, which revealed an intravesical textiloma. All foreign bodies were removed endoscopically, and the patient had a good post-operative outcome. Conclusion The rarity of the urological location of textilomas and the importance of their prevention remain a goal in surgery, whatever the specialty.
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Affiliation(s)
- Ghassane El Omri
- Department of Urology, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco
| | - Hamza Rais
- Department of Urology, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco
| | - Moussaab Rachid
- Department of Urology, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco
| | - Meryem Guennouni
- Department of Pediatrics, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco
| | - Abdeljalil Heddat
- Department of Urology, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco
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Seghers JK, Oyen T, Vandevenne JE. MRI of Paraspinal Gossypiboma: Look for the Barium Sulfate Filament. J Belg Soc Radiol 2023; 107:87. [PMID: 37954223 PMCID: PMC10637287 DOI: 10.5334/jbsr.3145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/05/2023] [Indexed: 11/14/2023] Open
Abstract
Gossypiboma is a rare post-surgical complication comprising a retained surgical gauze surrounded by a foreign body reaction. Although usually presenting on magnetic resonance imaging (MRI) with low T1 signal, high central and low peripheral signal on T2, and bandlike peripheral enhancement, MR appearance is often non-specific. The barium sulphate filament within a surgical gauze presents on MR as a curvilinear thread which is dark on both T1 and T2 sequences. Scrutinizing the MR images is critical to identify the filament and to pinpoint the diagnosis of gossypiboma. Teaching Point: A paraspinal mass on postoperative spine MRI should be carefully searched for a hypointense contorted wire (the barium sulfate filament), as it may be the characteristic finding to evocate the diagnosis of gossypiboma.
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Affiliation(s)
| | - Tom Oyen
- Ziekenhuis Oost-Limburg (ZOL), Genk, BE
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Diaouga HS, Yacouba MC, Oumara M, Garba RM, Idi N, Nayama M. Textiloma complicating myomectomy: A case report. Int J Surg Case Rep 2023; 111:108874. [PMID: 37776689 PMCID: PMC10543976 DOI: 10.1016/j.ijscr.2023.108874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 09/23/2023] [Accepted: 09/23/2023] [Indexed: 10/02/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Textiloma or gossypiboma is a rare complication of pelvic surgery. It can mimic both, clinically, and radiologically an abscess, or a tumor, thus, making its diagnosis difficult and late. It can lead to a high morbidity and mortality rate for the patient and engages the surgeon's civil liability. CASE PRESENTATION We report a case of textiloma following a myomectomy in a 42 year old patient treated in our department. Textiloma was diagnosed three years after myomectomy. Treatment consisted of a second laparotomy to remove the textiloma without complication. DISCUSSION Incidence of textiloma varies from 1/833 to 1/32.672 but more often encountered in African surgical practice. Systematic counts of instruments, sponges and needles is not yet usual in our operating room. Through the analysis of this case, we call on surgeons to be more vigilant in order to avoid this serious medical error. CONCLUSION The aim of this study was to describe the intraoperative errors that led to the occurrence of the textiloma, depict the diagnostic difficulties of textiloma, and the medico-legal implications in a tertiary hospital in Niger.
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Affiliation(s)
- Hamidou Soumana Diaouga
- Abdou Moumouni University, Department of Obstetrics and Gynecology, Maternity Issaka Gazobi in Niamey, Niger.
| | - Maimouna Chaibou Yacouba
- Abdou Moumouni University, Department of Obstetrics and Gynecology, Maternity Issaka Gazobi in Niamey, Niger
| | - Maina Oumara
- Abdou Moumouni University, Department of Obstetrics and Gynecology, General Reference Hospital in Niamey, Niger
| | - Rahamatou Madeleine Garba
- Abdou Moumouni University, Department of Obstetrics and Gynecology, Maternity Issaka Gazobi in Niamey, Niger
| | - Nafiou Idi
- Abdou Moumouni University, Department of Obstetrics and Gynecology, Maternity of the Regional Hospital of Niamey, Niger
| | - Madi Nayama
- Abdou Moumouni University, Department of Obstetrics and Gynecology, Maternity Issaka Gazobi in Niamey, Niger
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Min J, Lee S, Kim WJ, Kim SE. A Case Report of Neglected Gossypiboma Causing Abdominal Pain for 20 Years Post-Cesarean Section. J Menopausal Med 2022; 28:139-141. [PMID: 36647278 PMCID: PMC9843038 DOI: 10.6118/jmm.22022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 11/06/2022] Open
Abstract
Gossypiboma refers to a mass usually made of cotton (e.g., surgical gauze or sponge) that is accidentally left in a patient's body during surgery. We report the case of a 54-year-old multigravida menopausal woman who previously underwent cesarean section to deliver her second child. She was referred to our medical center after a 7 cm right ovarian mass with malignant potential was discovered. A diagnostic laparotomy was performed then confirmed the presence of a 10 cm gossypiboma attached to a metallic ring. This case is an alarming example highlighting the importance of adequate intraoperative counting of gauze and radiologic evaluation of chronic pelvic pain.
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Affiliation(s)
- Jisong Min
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Saemi Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won-ji Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Eun Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Shyam K, Bhari Thippeswamy P, Shetty AP, Algeri R, Rajasekaran S. Gauze for concern: A Case Report and systematic review of delayed presentation of paraspinal textiloma. J Clin Orthop Trauma 2022; 32:101967. [PMID: 36051862 PMCID: PMC9424584 DOI: 10.1016/j.jcot.2022.101967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/01/2022] [Indexed: 10/15/2022] Open
Abstract
Textilomas, gossypibomas, muslinomas and gauzomas, otherwise collectively known as Retained Non-absorbable Hemostatic Material (RNHM), are surgical materials such as cotton or gauze pads that are accidentally retained in the surgical bed post-operatively. They may present acutely with signs of infection or may rarely remain chronic and asymptomatic; the latter posing a significant challenge to clinical and imaging diagnosis. Textilomas are not routinely reported due to their medicolegal implications and are usually encountered fortuitously. Here, we report a case of an individual who presented with a non-specific lower backache, had a remote history of lumbar discectomy and in whom a textiloma at the postoperative site was seen to mimic a soft-tissue mass on imaging. In addition, we review current, up-to-date literature on delayed presentations of such retained materials after surgery of the lumbar spine. Case report A 43-year-old male presented with pain in his right lower back and gluteal region. He had undergone an L4-L5 discectomy 11 years ago, remained asymptomatic since, and noticed an insidious, worsening pain a week before presentation. Mild tenderness was elicited over the region of pain. A clinical diagnosis of L4-L5 extraforaminal disc prolapse with deep surgical site infection was made. Ultrasound showed an iso-to-hyperechogenic lesion in the right lower paraspinal region. MRI showed a very well-defined, ovoid T1-hypointense and T2-iso-hypointense lesion in the deep posterior paraspinal region of the L4/5 level adjacent to right laminar process of L4 vertebra. The lesion caused scalloping and chronic erosion of the laminar process. No obvious air pockets were present. The features of infection, like soft tissue oedema and collection, were absent. Based on imaging, differentials of nerve sheath tumour and gossipybomas was made. Open wound exploration was performed, which showed a wad of gauze within the right L4-L5 interlaminar space, with thin surrounding granulation tissue. The L4-L5 disc and exiting nerve root were normal. The mass was removed, local washing was done and wound was closed. Conclusion Though unfortunate and relatively rare, the possibility of a textiloma must be considered among the differential diagnoses of a mass in the spinal region in the event of prior surgery, no matter how remote the history. Clinical presentation may vary, but the imaging appearance is largely consistent and can be relied upon to prevent unnecessary investigation and facilitate early surgical removal of the offending retained material.
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Affiliation(s)
- Karthik Shyam
- Department of Radiology, Ganga Medical Center and Hospital, Mettupalayam Main Road, Coimbatore, Tamil Nadu, 641009, India
| | - Pushpa Bhari Thippeswamy
- Department of Radiology, Ganga Medical Center and Hospital, Mettupalayam Main Road, Coimbatore, Tamil Nadu, 641009, India
| | - Ajoy Prasad Shetty
- Department of Radiology, Ganga Medical Center and Hospital, Mettupalayam Main Road, Coimbatore, Tamil Nadu, 641009, India
| | - Raksha Algeri
- Department of Radiology, Ganga Medical Center and Hospital, Mettupalayam Main Road, Coimbatore, Tamil Nadu, 641009, India
| | - Shanmuganathan Rajasekaran
- Department of Radiology, Ganga Medical Center and Hospital, Mettupalayam Main Road, Coimbatore, Tamil Nadu, 641009, India
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8
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Munihire JB, Valimugighe MM, Martin NW. Mesenteric textiloma early discovery in a 31-year-old female: A case report. Int J Surg Case Rep 2022; 97:107439. [PMID: 35914478 DOI: 10.1016/j.ijscr.2022.107439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/16/2022] [Accepted: 07/17/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Textilloma or Gossypiboma refers as surgical sponges left behind in the surgical field during surgery. Although rare, occur commonly in practice and such cases are rarely encountered in the literature due to their under-reporting. A retained surgical sponge is an avoidable surgical complication that can lead to patient morbidity, mortality and profound medico-legal implications. CASE PRESENTATION We report a case of intra-abdominal textiloma discovered early in a 31-year-old woman who underwent cesarean section due to placenta previa. DISCUSSION This complication in our surgical practice is still relevant despite the popularization of the World Health Organization checklist. CONCLUSION The purpose of reporting this case is to awaken practitioners to be more vigilant and avoid such circumstances.
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9
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Fouad A, Bouab M, Youssouf N, Lamrissi A, Fichtali K, Bouhya S. Uterine necrosis simulating a textiloma: A case report. Int J Surg Case Rep 2022; 91:106754. [PMID: 35051885 DOI: 10.1016/j.ijscr.2021.106754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/16/2021] [Accepted: 12/31/2021] [Indexed: 11/21/2022] Open
Abstract
Uterine necrosis is a rare condition, it is considered a life-threatening complication. A few cases of uterine necrosis are reported in the literature most of them complicating embolizations, occurring after postpartum hemorrhages or severe endometritis. We describe a case of uterine necrosis occurring after a caesarean section, the results of the CT scan simulated a textiloma.
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10
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Hajri A, Touimi KB, El Berni Y, Erguibi D, Boufettal R, Rifki Jai S, Chehab F. Abdominal textiloma mimicking as gastrointestinal stromal tumor: A case report. Ann Med Surg (Lond) 2021; 70:102795. [PMID: 34584681 PMCID: PMC8453213 DOI: 10.1016/j.amsu.2021.102795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/25/2021] [Accepted: 09/02/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction and importance Gossypiboma or textiloma is a mass comprising of cotton matrix within the body left accidentally during a surgical procedure. The body may react to this foreign body through an exudative inflammatory reaction or an aseptic fibrotic reaction in order to encapsulate the cotton material and result into a mass. Case presentation We report a case of 65-year-old female. She was referred to our department due to 2 episodes of nausea and vomiting. She had history of open cholecystetomy 29 years ago, then cure for eventration one year after. On exploratory laparotomy there was a mass measuring 6 cm axis at the expense of segment 3 of the liver coming into intimate contact with the duodenum. Atypical segmental hepatectomy of segment 3 of liver was performed, and the histological report confirmed necrotic textiloma. Clinical discussion Textiloma represents a complication of all forms of surgery. It is a real, serious but preventable surgical complication, and could present with various complaints. Prevention of this condition can be achieved by meticulous count of surgical materials. Conclusion The embarrassment faced by the surgeon and the medico legal implications of this iatrogenic complication are tremendous and all preventive measures should be taken to avoid this as no excuse is justifiable. Gossypiboma is a mass comprising of cotton matrix within the body left accidentally during a surgical procedure. Gossypiboma is a serious but avoidable complication. It has serious medicolegal implications and negative impact on medical fraternity. Surgical and nursing team should be careful and ensure counts of surgical items during and at the end of surgery.
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Affiliation(s)
- Amal Hajri
- Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.,Department of Digestive Cancer Surgery and Liver Transplantation, CHU Ibn Rochd, Casablanca, Morocco
| | - Kenza Benjelloun Touimi
- Department of Digestive Cancer Surgery and Liver Transplantation, CHU Ibn Rochd, Casablanca, Morocco
| | - Yassine El Berni
- Department of Digestive Cancer Surgery and Liver Transplantation, CHU Ibn Rochd, Casablanca, Morocco
| | - Driss Erguibi
- Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.,Department of Digestive Cancer Surgery and Liver Transplantation, CHU Ibn Rochd, Casablanca, Morocco
| | - Rachid Boufettal
- Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.,Department of Digestive Cancer Surgery and Liver Transplantation, CHU Ibn Rochd, Casablanca, Morocco
| | - Saad Rifki Jai
- Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.,Department of Digestive Cancer Surgery and Liver Transplantation, CHU Ibn Rochd, Casablanca, Morocco
| | - Farid Chehab
- Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.,Department of Digestive Cancer Surgery and Liver Transplantation, CHU Ibn Rochd, Casablanca, Morocco
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11
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Hammadieh AR, Alsabek MB, Rustom S. Textiloma mimicking Crohn's disease in its features: A case report. Ann Med Surg (Lond) 2021; 62:283-287. [PMID: 33537144 PMCID: PMC7841073 DOI: 10.1016/j.amsu.2021.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/05/2021] [Accepted: 01/08/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction and importance Textiloma is a retained surgical item such as a sponge or gauze that is unintentionally left in the surgical field after the wound closure. Here, we present the first reported surgical gauze that penetrated the intestine, made a duodenal-ceca fistula and then stuck far away in the ileum. Mechanical obstruction didn't appear clinically or even in radiological investigations because of the fistula which provided the intestinal continuity. Case presentation We report a 34-year-old man with a previous abdominal interventions complained of cramping, frequent vomiting and presence of undigested food in stool. The frequency of the bowel movement increased recently. Endoscopies, radiological investigations and pathological findings figure out a duodenal-ceca fistula with nonspecific inflammatory tissues in the intestinal biopsy. When we performed the abdomen surgery, retained gauze in the ileum was taken out and the duodenal-ceca fistula was fixed. Clinical discussion Gauze or sponge that is forgotten in the surgical field called gossypiboma, textiloma, gauzoma or cottonoid. It could present with various complaints; as an acute or chronic problem, clear or ambiguous symptoms. It could reside in a space; extend across a gap, migrate through a tissue, or even make a fistula between lumina like in our case. Conclusion Textiloma could change pre-operative diagnosis, intra-operative techniques, postoperative follow-up plan and prognosis. This is the first report proves its ability to mimic inflammatory diseases that penetrate two different lumina and perform fistula. So it should be written in the list of any differential diagnosis when the patient has a previous procedure or surgery. Textiloma couldn't be always diagnosed preoperatively. It could give unrelated symptoms to its mass effect or contaminated problems. It could mimic Crohn's disease clinically, radiologically and even pathologically. It is a deferential diagnosis for every patient who has a previous procedure or surgery. Exploring the whole entire abdomen is necessary before performing the techniques.
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Affiliation(s)
- Abdul Rahman Hammadieh
- Department of Surgery, Almouwasat University Hospital, Damascus University, Faculty of Medicine, Damascus, Syria
| | - Mhd Belal Alsabek
- Department of Surgery, Almouwasat University Hospital, Damascus University, Faculty of Medicine, Damascus, Syria.,Department of Surgery, Syrian Private University, Faculty of Medicine, Damascus, Syria
| | - Sara Rustom
- Department of Surgery, Syrian Private University, Faculty of Medicine, Damascus, Syria
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12
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Sankpal J, Tayade M, Rathore J, Parikh A, Gadekar D, S SF, Sankpal S. Oh, My Gauze !!!- A rare case report of laparoscopic removal of an incidentally discovered gossypiboma during laparoscopic cholecystectomy. Int J Surg Case Rep 2020; 72:643-646. [PMID: 32513591 PMCID: PMC7365772 DOI: 10.1016/j.ijscr.2020.04.058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/04/2020] [Accepted: 04/20/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION The work has been reported in line with the SCARE criteria. The most common retained foreign body during surgery is woven cotton surgical sponge, which includes both laparotomy pads and smaller sponges. Sponges are easily retained because of their ubiquitous use, relatively small size and when soaked in blood, sponges conform to and can be difficult to distinguish from surrounding tissues. The problem of retained surgical sponge is known as gossypiboma, and also as 'textiloma', 'gauzoma' or 'muslinoma'. The number of preoperatively diagnosed cases treated by laparoscopic approach is rare in the literature and laparoscopic removal of incidentally detected gossypiboma with concomitant laparoscopic cholecystectomy is not yet reported in the literature. PRESENTATION OF CASE In 40-year-old female with caesarean section 5 years ago, now during elective laparoscopic cholecystectomy and umbilical hernia repair, an incidentally detected Gossypiboma was encountered. The Gossypiboma was safely excised by laparoscopic technique followed by laparoscopic cholecystectomy and open hernia repair. DISCUSSION Postoperative complications following surgery are common and mostly unavoidable but some like the gossypiboma are infrequent and avoidable. Most of them are asymptomatic and present in the body for a long period of time. However, once discovered these foreign bodies must be removed for which laparoscopy proves to be a better approach. Most of these cases also are under-reported due to medicolegal implications. CONCLUSION Gossypiboma is one of the preventable complications of surgery by the compliance of certain measures perioperatively. If detected incidentally, it can be safely managed laparoscopically with a shorter post-operative hospital stay and better cosmetic results.
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Affiliation(s)
- Jitendra Sankpal
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India.
| | - Mukund Tayade
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
| | - Jai Rathore
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
| | - Atish Parikh
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
| | - Deepak Gadekar
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
| | - Shaba Fathima S
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
| | - Sushrut Sankpal
- Grant Government Medical College & Sir, JJ Group of Hospitals, Mumbai, India
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Mace T, Kahn A, Dechaufour P, Kün-Darbois JD. An extremely rare case of a displaced third molar into the infratemporal fossa associated with a textiloma. J Stomatol Oral Maxillofac Surg 2020; 121:746-748. [PMID: 32302800 DOI: 10.1016/j.jormas.2020.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 04/08/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Third molar extraction is one of the most common procedures performed by oral surgeons, however with rare complications. The accidental displacement of a maxillary third molar into the infratemporal fossa (ITF) is a rare complication that can occur even with experienced surgeons. CASE PRESENTATION We describe the case of a 17-year-old patient whose right upper third molar was accidentally pushed to the ITF associated with a cellulitis and the late discovery of a textiloma (a surgical gauze). CONCLUSIONS Extraction of third molars is a safe surgical procedure when performed in appropriate conditions. The diagnosis of textiloma following a maxillo-facial surgery is extremely rare. It is important to take into account this possibility in order to avoid delaying treatment when it occurs.
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Affiliation(s)
- T Mace
- Department of Oral and Maxillofacial surgery, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex, France
| | - A Kahn
- Department of Oral and Maxillofacial surgery, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex, France.
| | - P Dechaufour
- Department of Oral and Maxillofacial surgery, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex, France
| | - J-D Kün-Darbois
- Department of Oral and Maxillofacial surgery, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex, France
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Bechtold R, Garlow B, Liu R, Tandon A, Szewc A, Zhu W, Musmanno O, Gorelick N, Suk I, Huang J, Brem H, Manbachi A, Coles G. Minimizing cotton ball retention in neurological procedures. Proc Des Med Devices Conf 2020; 2020:V001T06A006. [PMID: 35253016 PMCID: PMC8895243 DOI: 10.1115/dmd2020-9042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Neurosurgical operations are long and intensive medical procedures, during which the surgeon must constantly have an unobscured view of the brain in order to be able to properly operate, and thus must use a variety of tools to clear obstructions (like blood and fluid) from the operating area. Currently, cotton balls are the most versatile and effective option to accomplish this as they absorb fluids, are soft enough to safely manipulate the brain, act as a barrier between other tools and the brain, and function as a spacer to keep anatomies of the brain open and visible during the operation. While cotton balls allow neurosurgeons to effectively improve visibility of the operating area, they may also be accidentally left in the brain upon completion of the surgery. This can lead to a wide range of post-operative risks including dangerous immune responses, additional medical care or surgical operations, and even death. This project seeks to develop a unique medical device that utilizes ultrasound technology in order to minimize cotton retention after neurosurgical procedures in order to reduce undesired post-operative risks, and maximize visibility.
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Affiliation(s)
| | - Benjamin Garlow
- Johns Hopkins University, Baltimore, Maryland, United States
| | - Renee Liu
- Johns Hopkins University, Baltimore, Maryland, United States
| | - Arushi Tandon
- Johns Hopkins University, Baltimore, Maryland, United States
| | - Alexandra Szewc
- Johns Hopkins University, Baltimore, Maryland, United States
| | - William Zhu
- Johns Hopkins University, Baltimore, Maryland, United States
| | - Olivia Musmanno
- Johns Hopkins University, Baltimore, Maryland, United States
| | - Noah Gorelick
- Johns Hopkins Medical Institution, Baltimore, Maryland, United States
| | - Ian Suk
- Johns Hopkins Medical Institution, Baltimore, Maryland, United States
| | - Judy Huang
- Johns Hopkins Medical Institution, Baltimore, Maryland, United States
| | - Henry Brem
- Johns Hopkins Medical Institution, Baltimore, Maryland, United States
| | - Amir Manbachi
- Johns Hopkins Medical Institution, Baltimore, Maryland, United States
| | - George Coles
- Applied Physics Laboratory, Laurel, Maryland, United States
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Omar AS, Mohammed AA. Retained intra-abdominal surgical sponge causing ileocolic fistula diagnosed by colonoscopy. Int J Surg Case Rep 2020; 67:62-5. [PMID: 32007866 DOI: 10.1016/j.ijscr.2020.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/06/2020] [Accepted: 01/19/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Retained surgical sponges and instruments is a well-recognized medical error that may occur after all kinds of surgeries. This event has a catastrophic impact on the patient, health care workers, and the health institution. Sometimes, it is termed as textiloma or gossypiboma. CASE PRESENTATION A 40-year-old lady presented with abdominal pain, diarrhea and bilious vomiting for 3 days. The patients had history of cesarean section which was performed before 4 months. During examination she was pale and she had tenderness in the lower abdomen. CT-scan of the abdomen showed thickening of the wall of the sigmoid colon with evidence of intramural air and dilated small bowel loops. Colonoscopy showed evidence of surgical sponge causing transmural erosion and ulceration of the sigmoid colon. During surgery there was an evidence of a retained surgical sponge resulting in fistula between the ileum and the sigmoid colon. Resection of the involved part of the ileum and the sigmoid colon was done with end-end anastomosis. After 10 days she developed complete abdominal dehiscence. An emergency operation was performed for the patient and the abdomen was closed with tension sutures. CONCLUSION The surgical team is responsible for preventing this event by careful inspection of the surgical site using all the available methods and technology. Technology increases the safety but doesn't accurately prevent the accidents. All causative human and technical factors must be addressed carefully.
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Bechtold R, Tselepidakis N, Garlow B, Glaister S, Zhu W, Liu R, Szewc A, Tandon A, Buono Z, Pitingolo J, Madalo C, Ferrara I, Shale C, Benassi T, Belzberg M, Gorelick N, Hwang B, Molina CA, Coles G, Tyler B, Suk I, Huang J, Brem H, Manbachi A. Minimizing cotton retention in neurosurgical procedures: which imaging modality can help? Proc SPIE Int Soc Opt Eng 2020; 11317:1131704. [PMID: 35350430 PMCID: PMC8958457 DOI: 10.1117/12.2548847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Cotton balls are used in neurosurgical procedures to assist with hemostasis and improve vision within the operative field. Although the surgeon can reshape pieces of cotton for multiple intraoperative uses, this customizability and scale also places them at perpetual risk of being lost, as blood-soaked cotton balls are visually similar to raw brain tissue. Retained surgical cotton can induce potentially life-threatening immunologic responses, impair postoperative imaging, lead to a textiloma or misdiagnosis, and/or require reoperation. This study investigated three imaging modalities (optical, acoustic, and radiographic) to find the most effective method of identifying foreign bodies during neurosurgery. First, we examined the use of dyes to increase contrast between cotton and surrounding parenchyma (optical approach). Second, we explored the ability to distinguish surgical cotton on or below the tissue surface from brain parenchyma using ultrasound imaging (acoustic approach). Lastly, we analyzed the ability of radiography to differentiate between brain parenchyma and cotton. Our preliminary testing demonstrated that dark-colored cotton is significantly more identifiable than white cotton on the surface level. Additional testing revealed that cotton has noticeable different acoustic characteristics (eg, speed of sound, absorption) from neural tissue, allowing for enhanced contrast in applied ultrasound imaging. Radiography, however, did not present sufficient contrast, demanding further examination. These solutions have the potential to significantly reduce the possibility of intraoperative cotton retention both on and below the surface of the brain, while still providing surgeons with traditional cotton material properties without affecting the surgical workflow.
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Affiliation(s)
- Raphael Bechtold
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Niki Tselepidakis
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Benjamin Garlow
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Sean Glaister
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - William Zhu
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Renee Liu
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Alexandra Szewc
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Arushi Tandon
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Zachary Buono
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - James Pitingolo
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Cristina Madalo
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Isabella Ferrara
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Collin Shale
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Thomas Benassi
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | - Micah Belzberg
- Department of Plastic Surgery, Johns Hopkins University, Baltimore, MD
| | - Noah Gorelick
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD
| | - Brian Hwang
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD
| | - Camilo A Molina
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD
| | - George Coles
- Johns Hopkins Applied Physics Laboratory, Laurel, MD
| | - Betty Tyler
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD
| | - Ian Suk
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD
| | - Judy Huang
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD
| | - Henry Brem
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD
| | - Amir Manbachi
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD
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Montemurro N, Murrone D, Romanelli B, Ierardi A. Postoperative Textiloma Mimicking Intracranial Rebleeding in a Patient with Spontaneous Hemorrhage: Case Report and Review of the Literature. Case Rep Neurol 2020; 12:7-12. [PMID: 32009930 PMCID: PMC6984157 DOI: 10.1159/000505233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 12/03/2019] [Indexed: 11/24/2022] Open
Abstract
During craniotomy, hemostatic materials such as oxidized cellulose and cotton pads, commonly used to control bleeding, may cause a granulomatous reaction that may produce space-occupying mass lesions termed textiloma (or gossypiboma). We present a 46-year-old female who underwent a right frontotemporal craniotomy and surgical removal of intraparenchymal cerebral hemorrhage, and who developed a textiloma during the postoperative period causing seizures. Granulomatous reactions due to hemostatic agents have been reported experimentally, as well as after cranial and spinal operations. We emphasize that although it is rare, an adverse reaction such as a postoperative textiloma due to hemostatic material and subsequent granuloma formation can result in a false image of rebleeding, tumor recurrence, radiation necrosis, or postoperative abscess, depending on the particular clinical history of each patient.
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Affiliation(s)
- Nicola Montemurro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.,Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy
| | - Domenico Murrone
- Unit of Neurosurgery, "Di Venere" City Hospital, ASL Bari, Bari, Italy
| | - Bruno Romanelli
- Unit of Neurosurgery, "Di Venere" City Hospital, ASL Bari, Bari, Italy
| | - Aldo Ierardi
- Unit of Neurosurgery, "Di Venere" City Hospital, ASL Bari, Bari, Italy
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Lebas L, Dupuis M, Solovei L, Jaffro M, Grunenwald E, Pontier-Marchandise S, Dahan M, Didier A. [Twenty years later… A story of intra-thoracic textiloma]. Rev Mal Respir 2019; 36:214-8. [PMID: 30446182 DOI: 10.1016/j.rmr.2018.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 04/03/2018] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Intrathoracic textiloma is a rare complication possibly leading to misdiagnosis. It could present as haemoptysis, lung abscess, pseudo-tumour or a chronic cough. CASE REPORT A 65-year-old patient with a history of multiple cardiac problems and needing long-term anticoagulation, complained since 2007 of recurrent haemoptysis of increasing abundance, the etiological investigation of which was negative. A thoracic CT-scan revealed a lesion in the lingula in contact with the pericardial plates of an implanted automatic defibrillator dating from 1989. In 2016, after two failures of arterial embolization, a diagnostic and therapeutic surgical exploration was undertaken on this patient who was a high operative risk. A segmental resection revealed an intra-pulmonary textiloma on pathological examination. CONCLUSION The diagnosis of intrathoracic textiloma remains rare and its late presentation is non specific. Radiological imaging with a CT-scan and/or MRI could lead to the diagnosis. Surgery remains the reference treatment for the diagnosis and cure of intrathoracic textiloma with pathological examination, essential for confirmation. A means of prevention has to be developed because swab count is not totally reliable.
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Patial T, Rathore N, Thakur A, Thakur D, Sharma K. Transmigration of a retained surgical sponge: a case report. Patient Saf Surg 2018; 12:21. [PMID: 30127854 PMCID: PMC6087538 DOI: 10.1186/s13037-018-0168-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 07/27/2018] [Indexed: 01/04/2023] Open
Abstract
Background A retained surgical sponge remains a dreaded complication of modern surgery. Despite the increasing focus on patient safety instances of “a sponge being left in the abdomen”, are all too common in popular media. In this article we report the rare phenomenon of transmigration of a retained surgical sponge in a patient who underwent laparoscopic sterilization. Case presentation A 30-year-old female presented with progressive abdominal pain for about one month and vomiting with obstipation for 2 days. The patient had undergone laparoscopic sterilization 7 years back and then underwent re-canalization one year back. She underwent an exploratory laparotomy for suspected adhesive small bowel obstruction. During surgery, an intra-luminal surgical sponge was recovered from the distal small bowel. The patient recovered and was discharged in good health. Conclusion Despite numerous advances in terms of technology and the ever-growing emphasis on patient safety, the problem of a retained surgical sponge remains a dreaded potential complication. All clinicians and health care professionals should be aware of this entity and its various presentations.
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Affiliation(s)
- Tushar Patial
- The Clinic, Sanjauli, Shimla, Himachal Pradesh 171006 India
| | - Namit Rathore
- 2Department of General Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh India
| | - Angesh Thakur
- 3Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Digvijay Thakur
- 2Department of General Surgery, Indira Gandhi Medical College, Shimla, Himachal Pradesh India
| | - Kanika Sharma
- Department of Radiation Therapy, Rajiv Gandhi Cancer Hospital and Research Centre, New Delhi, India
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20
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Turgut M, Akhaddar A, Turgut AT. Retention of Nonabsorbable Hemostatic Materials (Retained Surgical Sponge, Gossypiboma, Textiloma, Gauzoma, Muslinoma) After Spinal Surgery: A Systematic Review of Cases Reported During the Last Half-Century. World Neurosurg 2018; 116:255-267. [PMID: 29807184 DOI: 10.1016/j.wneu.2018.05.119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/15/2018] [Accepted: 05/16/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Retention of nonabsorbable hemostatic materials (RNHMs), that is, retained surgical sponge, gauzoma, gossypiboma, muslinoma, or textiloma, is a rarely seen surgical complication after spinal surgery that may remain asymptomatic for many years and may represent a diagnostic difficulty with associated medicolegal implications. METHODS We performed a systematic review of the English-language literature published between 1965 and 2017, accessed through 4 popular databases. We found a total of 37 articles (24 case reports; 7 image presentations; 5 clinical series, and 1 letter to editor) containing 58 cases of RNHMs located within the spinal canal or around the spinal column after surgery. RESULTS In this study, there were 29 female and 29 male patients from 13 countries, ages ranging from 17 years to 87 years, with initial diagnoses of lumbar or cervical disc herniation, spinal stenosis, or spondylolisthesis (n = 54), or spinal tumor (n = 4). The interval from the initial surgery to the presentation of RNHMs ranged from 13 days to 40 years, with a mean of 75.9 months. Various imaging techniques such as computed tomography and magnetic resonance imaging were used with histologic study, confirming the presence of RNHMs in the majority of patients with a complete recovery resulting in 93% of patients. CONCLUSIONS RNHMs is an overreported entity in underdeveloped or developing countries, including Turkey and Morocco, with progression occurring over years. RNHMs should be considered in the differential diagnosis of any patient who presents with back pain, spinal cord, or nerve roots symptomatology after spinal surgery.
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Affiliation(s)
- Mehmet Turgut
- Department of Neurosurgery, Adnan Menderes University School of Medicine, Aydın, Turkey.
| | - Ali Akhaddar
- Department of Neurosurgery, Avicenne Military Hospital of Marrakech, Mohammed V. University in Rabat, Rabat, Morocco
| | - Ahmet T Turgut
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
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21
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Gadelkareem RA. Experience of a Tertiary-Level Urology Center in the Clinical Urological Events of Rare and Very Rare Incidence. I. Surgical Never Events: 2. Intracorporeally-Retained Urological Surgical Items. Curr Urol 2018; 11:151-156. [PMID: 29692695 PMCID: PMC5903471 DOI: 10.1159/000447210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/28/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Presentation of our center's experience in the management of intracorporeally-retained urological surgical items. MATERIALS AND METHODS Retrospective search of our center's data for cases of retained surgical items during the period July 2006 to June 2016. Each case was studied for the demographic and clinical variables including types, presentation, and management. RESULTS Out of more than 55,000 different urological interventions, only 39 cases (28 males and 11 females) had retained surgical items. Urolithiasis-related urological subspecialties were more involved than others. Forgotten items and technically-retained items occurred in 38.5 and 61.5% of cases, respectively, and were immediately discovered or discovered up to 10 years later. Material types were textiles, biosynthetics, and metallics in 31, 51, and 18%, respectively. Possible predisposing factors included complex surgeries, emergent intraoperative events, and extra approaches. Occurrences of retained surgical items before and after implemented corrective actions were 74.6 and 25.4%, respectively. All the final outcomes were either short- or long-term harm without deaths, organ losses, or permanent disabilities. CONCLUSION Retained urological surgical items are surgical never events that result from forgetfulness or technical surgical human errors. Their sequels can be potentially fatal, but they are preventable and can be significantly reduced.
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Affiliation(s)
- Rabea A. Gadelkareem
- *Rabea A. Gadelkareem, Elgamaa Street, Faculty of Medicine, Assiut University, EG-71515 Assiut (Egypt), E-Mail
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Affiliation(s)
- F Rasoaherinomenjanahary
- Service de chirurgie viscérale B., hôpital Joseph-Ravoahangy-Andrianavalona, CHU d'Antananarivo, route Nationale 1, Ampefiloha BP 4150 101 Antananarivo, Madagascar; Université d'Antananarivo, Antananarivo, Madagascar.
| | - D H Ranoharison
- Université d'Antananarivo, Antananarivo, Madagascar; Service de radiologie, CHU Joseph-Ravoahangy-Andrianavalona, Antananarivo, Madagascar
| | - L H Samison
- Service de chirurgie viscérale B., hôpital Joseph-Ravoahangy-Andrianavalona, CHU d'Antananarivo, route Nationale 1, Ampefiloha BP 4150 101 Antananarivo, Madagascar; Université d'Antananarivo, Antananarivo, Madagascar
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23
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Banerjee JK, Saranga Bharathi R, Mujeeb VR, Singh G. Retention of surgical sponge: An act of providence? Med J Armed Forces India 2017; 72:S138-S141. [PMID: 28050095 DOI: 10.1016/j.mjafi.2016.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 01/23/2016] [Indexed: 10/22/2022] Open
Affiliation(s)
- J K Banerjee
- Consultant (Surg & GI Surg), Command Hospital (Southern Command), Pune 411040, India
| | - R Saranga Bharathi
- Classified Specialist (Surg & GI Surg), Command Hospital (Southern Command), Pune 411040, India
| | - V R Mujeeb
- Senior Advisor (Gastroenterology), Command Hospital (Southern Command), Pune 411040, India
| | - Giriraj Singh
- Senior Advisor (Radiology), Command Hospital (Southern Command), Pune 411040, India
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Mercier M, Noailles T, Sali E, Carret P, Duvauferrier R, Rouvillain JL. What type of imaging work-up will help to confirm the diagnosis of gossypiboma in the limb? Review of literature. Orthop Traumatol Surg Res 2016; 102:795-800. [PMID: 27521180 DOI: 10.1016/j.otsr.2016.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 06/17/2016] [Accepted: 06/17/2016] [Indexed: 02/02/2023]
Abstract
UNLABELLED Gossypiboma imaging features are not well known and are often confused with soft tissue tumours. Publications on this topic mainly consist of case reports and small cohorts. Its appearance on various imaging modalities is not well defined. This led us to carry out a review of literature to determine specifically: (1) which imaging modalities should be used in cases of suspected gossypiboma, (2) what are the most common imaging findings that contribute to the diagnosis of gossypiboma. An exhaustive review of literature was carried out in June 2015 in the Medline, PubMed and Cochrane databases using the keywords "gossypiboma/textiloma/foreign body". We found 205 articles describing one or multiple cases of gossypiboma in various locations. Of these, the 32 articles that had imaging data were chosen - 16 for the limbs and 16 for other locations. The type of imaging carried out, description of the gossypiboma and circumstances of the discovery and occurrence were recorded. Descriptive statistics were generated to define the type of imaging used and the various findings. Imaging consisted of X-rays in 21/32 cases (66%), computed tomography (CT) in 14/32 cases (43%), magnetic resonance imaging (MRI) in 21/32 cases (65%) and ultrasonography in 14/32 cases (43%). On X-rays, bone involvement was found in 9/15 cases (60%); there was peripheral contrast product uptake on the CT scans in 9/14 cases (64%), a hypointense signal on T1-weighted sequences on MRI in 6/13 cases (46%) and lack of vascularisation in 8/13 cases (62%) and a acoustic shadow on ultrasonography in 9/14 cases (64%). In a patient presenting with a soft tissue lump and history of surgery, an imaging work-up including X-rays, ultrasonography and MRI must be performed. Bone involvement on X-rays, acoustic shadowing on ultrasonography and hypointense signal on T1-weighted MRI sequences with lack of vascularisation in combination with a history of surgery can bring up the possibility of gossypiboma. If there is a possibility of soft tissue tumour, the case should be discussed in a multidisciplinary meeting and a biopsy should be performed first. LEVEL OF EVIDENCE IV - systematic analysis of published retrospective studies.
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Affiliation(s)
- M Mercier
- Service d'orthopédie et traumatologie, CHU de Martinique, CS90632, 97261 Fort-de-France, Martinique
| | - T Noailles
- Service d'orthopédie et traumatologie, CHU de Martinique, CS90632, 97261 Fort-de-France, Martinique
| | - E Sali
- Service d'orthopédie et traumatologie, CHU de Martinique, CS90632, 97261 Fort-de-France, Martinique
| | - P Carret
- Service d'orthopédie et traumatologie, CHU de Martinique, CS90632, 97261 Fort-de-France, Martinique
| | - R Duvauferrier
- Service de radiologie, CHU de Martinique, 97261 Fort-de-France, Martinique
| | - J L Rouvillain
- Service d'orthopédie et traumatologie, CHU de Martinique, CS90632, 97261 Fort-de-France, Martinique.
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Maier M, Bratschitsch G, Friesenbichler J, Bodo K, Leithner A, Holzer LA. Pathologic fracture of the distal humerus due to a textiloma. J Shoulder Elbow Surg 2016; 25:e304-8. [PMID: 27663747 DOI: 10.1016/j.jse.2016.07.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 07/04/2016] [Accepted: 07/19/2016] [Indexed: 02/01/2023]
Affiliation(s)
- Michael Maier
- Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria
| | | | - Jörg Friesenbichler
- Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria
| | - Koppany Bodo
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Andreas Leithner
- Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria
| | - Lukas A Holzer
- Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria.
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Lee S, Kim B, Kim JS, Choi BS. A 20-Year-Old Retained Surgical Gauze Mimicking a Spinal Tumor: A Case Report. Korean J Spine 2016; 13:160-163. [PMID: 27799998 PMCID: PMC5086470 DOI: 10.14245/kjs.2016.13.3.160] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/19/2016] [Accepted: 07/25/2016] [Indexed: 11/19/2022]
Abstract
A 79-year-old man visited our clinic complaining of lower back and left leg radiating pain that began 1 month prior to his presentation. He underwent surgery for lumbar disc herniation 20 years ago at another hospital. Magnetic resonance imaging revealed left-sided foraminal stenosis at L4-5. In addition, a paraspinal mass occupying the L4 spinous process and left lamina was observed. We subsequently performed an L4-5 decompression and fusion. During the operation, retained surgical gauze with granulation tissue was found. The term gossypiboma is used to define a mass lesion consisting of retained surgical gauzes and an adjacent foreign body reaction. Gossypibomas are uncommon in the paraspinal area and are mostly asymptomatic in chronic cases. Because there are no specific clinical or radiological signs, they can be confused with other tumorous conditions. Gossypibomas should be included in the differential diagnosis of paraspinal soft-tissue masses detected in patients with a history of prior spinal surgery.
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Affiliation(s)
- Sungjoon Lee
- Department of Neurosurgery, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Bomi Kim
- Department of Pathology, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Jung Soo Kim
- Department of Neurosurgery, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Byeong Sam Choi
- Department of Neurosurgery, Inje University Haeundae Paik Hospital, Busan, Korea
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Shin WY, Im CH, Choi SK, Choe YM, Kim KR. Transmural penetration of sigmoid colon and rectum by retained surgical sponge after hysterectomy. World J Gastroenterol 2016; 22:3052-3055. [PMID: 26973401 PMCID: PMC4779928 DOI: 10.3748/wjg.v22.i10.3052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/23/2015] [Accepted: 11/24/2015] [Indexed: 02/06/2023] Open
Abstract
Gossypiboma is a surgical sponge that is retained in the body after the operation. A 39-year-old female presented with vague lower abdominal pain, fever, and rectal discharge 15 mo after hysterectomy. The sponge remaining in the abdomen had no radiopaque marker. Therefore a series of radiographic evaluations was fruitless. The surgical sponge was found in the rectosigmoid colon on colonoscopy. The sponge penetrated the sigmoid colon and rectum transmurally, forming an opening on both sides. The patient underwent low anterior resection and was discharged without postoperative complications.
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Balcázar-Rincón LE, Gordillo Gómez EA, Ramírez-Alcántara YL. [Intestinal occlusion secondary to a retained surgical item]. CIR CIR 2016; 84:503-8. [PMID: 26738642 DOI: 10.1016/j.circir.2015.06.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 06/05/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Retained surgical items after a surgical procedure is a real, existing, and preventable problem that affects the safety of the surgical patient. Its incidence is not exactly known due to under-reporting of occurrence, due to the potential risk of lawsuits. CLINICAL CASE A 31 year-old women that had an elective caesarean, apparently without complications. In the immediate post-operative period, clinical features appeared that were compatible with intestinal obstruction, such as inability to channel gas, bloating, abdominal pain and vigorous peristalsis. The diagnosis is made by the recent history of abdominal-pelvic surgery and the finding of a foreign body on a simple x-ray of the abdomen. The patient was operated upon, with a satisfactory outcome, and was discharged 5 days later. CONCLUSION A retained surgical instrument is an under-reported event that represents a medical-legal problem, leading to various complications, including death if it is not diagnosed and treated early. It is important to know the risk factors and adopt a culture of prevention through perioperative monitoring of equipment and instruments used during the surgical act.
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Rafat D, Hakim S, Sabzposh NA, Noor N. Gossypiboma mimicking as dermoid cyst of ovary: a case report. J Clin Diagn Res 2015; 9:QD01-2. [PMID: 25954669 PMCID: PMC4413119 DOI: 10.7860/jcdr/2015/12815.5633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 01/29/2015] [Indexed: 11/24/2022]
Abstract
Gossypiboma is a rare condition caused by retained postoperative foreign bodies. The condition is under reported because of diagnostic difficulties and medicolegal implications associated with it. It may mimic a benign or malignant soft-tissue tumour in the abdomen and pelvis. A 22-year-old woman presented with non specific symptoms and was referred to us with radiological diagnosis of dermoid cyst. On laparotomy the mass was proved to be a gossypiboma resulted from gauze which was retained in caesarean section done two years back. Although gossypiboma is rarely seen in daily clinical practice, it should be considered in the differential diagnosis of postoperative patients presenting with non specific complains and lump abdomen. Despite thorough history, physical examination, laboratory, and radiographical findings, usually gossypibomas are not suspected and remain an accidental finding. Employment of all preventive measures during surgical procedures and high index of suspicion in post operative patients are the key stones in its management.
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Affiliation(s)
- Dalia Rafat
- Assistant Professor, Department of Obstetrics & Gynaecology, J N Medical College & Hospital, Faculty of Medicine, Aligarh Muslim University, Aligarh, UP, India
| | - Seema Hakim
- Professor, Department of Obstetrics & Gynaecology, J N Medical College & Hospital, Faculty of Medicine, Aligarh Muslim University, Aligarh, UP, India
| | - Noor Afshan Sabzposh
- Professor, Department of Obstetrics & Gynaecology, J N Medical College & Hospital, Faculty of Medicine, Aligarh Muslim University, Aligarh, UP, India
| | - Nasreen Noor
- Assistant Professor, Department of Obstetrics & Gynaecology, J N Medical College & Hospital, Faculty of Medicine, Aligarh Muslim University, Aligarh, UP, India
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Fouelifack FY, Fouogue JT, Fouedjio JH, Sando Z. A case of abdominal textiloma following gynecologic surgery at the Yaounde Central Hospital, Cameroon. Pan Afr Med J 2013; 16:147. [PMID: 24876905 PMCID: PMC4031094 DOI: 10.11604/pamj.2013.16.147.3201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 11/09/2013] [Indexed: 11/13/2022] Open
Abstract
Textiloma is the inadvertent retention of a textile foreign body on the surgical site. It is a rare complication of surgery but which carries severe consequences for both patients and surgeons in terms of morbi-mortality and medico-legal procedures respectively. We herein report the case of an abdominal textiloma in a 42 year old woman who underwent a total abdominal hysterectomy for symptomatic leiomyomas. We also depict the errors that led to this mishap in a tertiary hospital in Yaounde (Cameroon). The textiloma was recognized six weeks after the causative surgery and removed by laparotomy without further complications.
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Affiliation(s)
- Florent Ymele Fouelifack
- Department of Obstetrics and Gynecology of the Yaoundé Central Hospital - Cameroon ; Research, Education and Health Development Associate's Group (REHDAG), Dschang, Cameroon
| | | | - Jeanne Hortence Fouedjio
- Department of Obstetrics and Gynecology of the Yaoundé Central Hospital - Cameroon ; Faculty of Medicine and biomedical Sciences of the University of Yaoundé I - Cameroon
| | - Zacharie Sando
- Faculty of Medicine and biomedical Sciences of the University of Yaoundé I - Cameroon ; Head of the Unit of the Yaoundé Gyneco-obstetrics and Pediatric Hospital, Cameroon
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Kato T, Yamaguchi K, Kinoshita K, Sasaki K, Kagaya H, Meguro T, Morita T, Takahashi T, Tamaki N, Horita S. Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine. Case Rep Gastroenterol 2012; 6:754-9. [PMID: 23341797 PMCID: PMC3551410 DOI: 10.1159/000346285] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A 56-year-old woman with a history of gynecological surgery for cervical cancer 18 years previously was referred to our hospital for colicky abdominal pain, nausea and vomiting. Intestinal obstruction was diagnosed by contrast-enhanced computed tomography (CT) which showed dilation of the small intestine and suggested obstruction in the terminal ileum. In addition, CT showed a thick-walled cavitary lesion communicating with the proximal jejunum. 18F-fluorodeoxyglucose positron emission tomography showed abnormal uptake at the same location as the cavitary lesion revealed by CT. The patient underwent laparotomy for the ileus and resection of the cavitary lesion. At laparotomy, we found a retained surgical sponge in the ileum 60 cm from the ileocecal valve. The cavitary tumor had two fistulae communicating with the proximal jejunum. The tumor was resected en bloc together with the transverse colon, part of the jejunum and the duodenum. Microscopic examination revealed fibrous encapsulation and foreign body giant cell reaction. Since a retained surgical sponge without radiopaque markers is extremely difficult to diagnose, retained surgical sponge should be considered in the differential diagnosis of intestinal obstruction in patients who have undergone previous abdominal surgery.
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Affiliation(s)
- Takashi Kato
- Department of Internal Medicine, Hokkaido Gastroenterology Hospital, Sapporo, Japan
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Kim YS, Lee HJ, Jeon JH, Park IJ. A 12-year-old chronic form textiloma after revision surgery for infected spinal instrumentation. Eur J Orthop Surg Traumatol 2012; 22 Suppl 1:53-6. [PMID: 26662748 DOI: 10.1007/s00590-011-0932-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Accepted: 12/08/2011] [Indexed: 10/14/2022]
Abstract
Retained surgical gauze and the surrounding foreign body reaction constitute a mass referred to as a textiloma. Textiloma has acute and chronic forms; the acute form is symptomatic in the early postoperative period and the chronic form may be asymptomatic or display mild and nonspecific symptoms. Usually, textiloma after previously infected surgery has acute forms. We report here on a case of a 46-year-old male who had retained surgical gauze for 12 years. The patient had received revision surgery for infected spinal instrumentation 12-years previously and had no specific symptom after surgery. One month prior to the present admission, the patient experienced low back pain and left thigh pain. Based on the prior operative history and present imaging results, the patient was diagnosed with an abscess due to a foreign body reaction. The patient underwent surgery, which discovered retained gauze with granuloma. This case is the third longest reported case after entire spinal surgery and the longest time of textiloma after previously infected spine surgery.
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Kawamura Y, Ogasawara N, Yamamoto S, Sasaki M, Kawamura N, Izawa S, Kobayashi Y, Kamei S, Miyachi M, Kasugai K. Gossypiboma mimicking gastrointestinal stromal tumor causing intestinal obstruction: a case report. Case Rep Gastroenterol 2012; 6:232-7. [PMID: 22679410 PMCID: PMC3369411 DOI: 10.1159/000338833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
A 41-year-old woman was admitted to our hospital with abdominal pain that developed about 1 year after a Cesarean section. Pelvic computed tomography (CT) revealed diffuse dilation of the small intestine with fluid shadows and a pelvic tumor 55 mm in diameter. The density of the tumor, which was not enhanced by intravenous contrast medium, was diffuse and similar to that of muscular tissue, whereas the density of a capsule surrounding the mass was relatively high. T1- and T2-weighted pelvic magnetic resonance imaging (MRI) of the tumor revealed the same diffuse low-intensity signals as muscular tissue, and diffuse high-intensity signals, respectively. The CT and MRI findings were consistent with those of a gastrointestinal stromal tumor (GIST) causing ileus of the small intestine. As inserting an ileus tube did not improve her symptoms, the patient was scheduled for tumor resection. The operative findings revealed a hard, solid tumor adhering to the surrounding small intestine. The macroscopic findings revealed that the tumor consisted of layers of stratified gauze surrounded by a thick granulomatous wall. The gossypiboma was considered to have originated from gauze that had been left behind after the Cesarean section. If a patient has a history of surgery, the possibility of gossypiboma should be considered when CT or MRI findings indicate features of GIST.
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Affiliation(s)
- Yurika Kawamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
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Abstract
Textiloma is defined as a tumor formed due to retained gauze. It is rarely reported in the musculoskeletal system. We are presenting a case with a soft tissue swelling over the lateral aspect of the lower third of the leg, come for implant removal of the distal tibia and fibular fracture. We removed the soft tissue mass enbloc thinking it to be a benign tumor. On cutting the mass on the operation table, a gauze piece encased by fibrous tissue was found. Textiloma can present as tumoral forms and can mimic as a pseudo-tumor.
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Affiliation(s)
- Amol C Patel
- Department of Orthopedics, Post Graduate Institute of Swashiyog Prathisthan, Extension Area, Miraj - 416 410, India,Correspondence: Dr Amol Patel, c/o Dr GS Kulkarni, Ortho and Fracture Hospital, Extension Area, Miraj - 416410, India. E-mail:
| | - Govind S Kulkarni
- Department of Orthopedics, Post Graduate Institute of Swashiyog Prathisthan, Extension Area, Miraj - 416 410, India
| | - Sunil G Kulkarni
- Department of Orthopedics, Post Graduate Institute of Swashiyog Prathisthan, Extension Area, Miraj - 416 410, India
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Abstract
We herein report a gossypiboma resulting from a retained surgical swab, which had been left in peritoneum for 20 years after appendectomy. CT revealed a cystic mass with a calcified reticulate rind. Subsequent surgery and pathological examination showed a gossypiboma. A simple experiment, using a barium-soaked surgical swab demonstrating similar CT appearance, supported our postulation that calcium deposition on the reticulated fibers of a surgical swab could generate such a characteristic “calcified reticulate rind” sign. We believe that identification of this CT sign facilitates the diagnosis of gossypibomas.
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Affiliation(s)
- Yi-Ying Lu
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Linkou, 5-Fu-Shing Street, Kwei Shan, TaoYuan, Taiwan, China
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