Gossypiboma - uterine
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Left-sided abdominal pain a few months after cesarean section surgery
CT abdomen and pelvis
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Sizable well circumscribed lower abdominal lesion is seen measuring about 9 x 7 x 8 cm in maximum dimensions. It shows heterogeneous non-specific appearance with multiple air bubbles (spongiform appearance) and hyperdense markers.
It is adherent/inseparable from the uterine fundus and the left adnexa which is enlarged (5 x 3.8 cm). This is associated with wall thickening of the sigmoid colon coupled with marked peri-colonic inflammatory fat stranding. IUCD is noted in a proper position.
Gossypiboma means a foreign body reaction to retained surgical sponge after operation inside a body cavity. It usually has a radio-opaque marker that makes it easily identified on X-ray.
CT is the modality of choice for confirming the diagnosis and assessment of the extent and relations of the associated inflammatory reaction.