C/o pain in right hypochondrium. H/o cholecystectomy 2 months back.
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Contrast CT abdomen scan reveals a relatively well-circumscribed heterogenous lesion with multiple air foci within in subhepatic region closely abutting gall bladder fossa and displacing antro-pyloric region of the stomach. There are mild perilesional fat stranding, minimal collection and peritoneal thickening. The lesion shows heterogeneous peripheral enhancement seen on the post-contrast study, mild circumferential wall thickening at the antro-pyloric region of the stomach adjacent to the lesion is noted suggesting reactive inflammation. Fistulous communication to the stomack antrum is noted.
Mild circumferential wall thickening of ascending colon, cecum and transverse colon- suggesting inflammation.
This case demonstrates the typical spongiform appearance of gossypiboma with multiple internal air foci in the postoperative bed. The patient underwent surgery and the retained surgical sponge was removed.