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Gossypiboma

Case contributed by Huda B. Gharbia
Diagnosis almost certain

Presentation

Lower abdominal pain, history of pelvic surgery four months ago.

Patient Data

Age: 45 years
Gender: Female
ct

There is a well-defined heterogenous lesion in left lower abdomen, which has a spongiform appearance with gas bubbles, and shows an enhancing wall with hyperdense curvilinear metallic structures in it. It is abutting the lower anterior abdominal wall, just above the level of the left ovary, with adjacent bowel loops (ileum, distal descending colon, proximal sigmoid) showing a diffuse thickened wall, surrounded by regional fatty stranding.

Also noted are signs of a lower abdominal incision, including subcutaneous thickening, edema and fluid collection.

Left ovarian cyst.

Case Discussion

Signs of recent lower abdominal surgery with a heterogenous intra-abdominal collection, with a spongiform appearance, suggestive of retained surgical sponge, i.e. likely gossypiboma.

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