Gossypiboma

Case contributed by Dr Ian Bickle

Presentation

Abdominal distension 2 weeks after urological surgery.

Patient Data

Age: 40 years
Gender: Male
X-ray

Linear artifact in the right flank with a mass like abnormality around it containing foci of gas. The linear artifact is typical of that purposely put into surgical gauze/packs.

Left ureteric stent

Dilated gas filled proximal small bowel in keeping with obstruction.

Case Discussion

Thankfully uncommon a gossypiboma describes when a foreign object, usually of fabric/textile origin, in left within the body following a surgical procedure.  The name is derived from the gossypium(Latin for cotton) and oma (Latin for a tumor or growth).

It is typically due to a swab or surgical pack being left behind - the latter in this case.

Frequently a collection develops around the foreign body. In addition in this case a small bowel obstruction occurred.

Theater do 'swab count' at the end of procedures, but as this case demonstrates it is not always fullproof. 

This case was proven at surgery.

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