Presentation
A female patient complained of abdominal pain and constipation for one-week duration. She had a history of previous appendectomy since one month.
Patient Data
A linear radio-opaque shadow is visible in the lower abdominal field in the scout view.
The abdominal CT scan shows this radio-opaque object related to a large, well-defined extraluminal spongiform lesion that is associated with dilatation of small bowel loops, features consistent with a retained surgical object (gossypiboma) with signs of small bowel obstructions.
A retrospective ultrasound shows a lesion with an echogenic surface and extensive acoustic shadow.
Case Discussion
Gossypibomas cause two types of responses in the body: exudative and aseptic fibrous. Aseptic gossypibomas can have adhesions, encapsulation, and eventually granuloma formation. Exudative gossypibomas, however, usually occur early in the postoperative period and may involve secondary bacterial contamination, which can result in various fistulas.
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