Abdominal gossypiboma: surgical towel

Case contributed by Dr Mohamed Abdel-Tawab Mohamed

Presentation

Presented with symptoms of intestinal obstruction. History of previous abdominal surgery.

Patient Data

Age: 25 years
Gender: Female

Mild ascites and small pneumoperitoneum. Dilated small intestinal loops. Colonic loops are seen collapsed

A well-defined structure is seen in the left iliac region with a density similar to that of faecal matter (gases and low-density content), however, it is not continuous with the colon or any other structures.

Bilateral small pleural effusions with underlying subsegmental lung collapse.

The uterus is enlarged with thickened endometrium.

Case Discussion

There is a missed surgical towel in the left region seen as spongiform appearance with gas bubbles. The previous history of abdominal surgery is key to diagnosis.

It can cause adhesions or even get infected resulting in an internal fistula. Some towels have a radio-opaque element to help detection by plain radiograph.

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Case information

rID: 57288
Published: 16th Dec 2017
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included
Institution: Assiut University

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