Gossypiboma - uterine

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Left-sided abdominal pain a few months after cesarean section surgery

Patient Data

Age: 25 years
Gender: Female

CT abdomen and pelvis

ct

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.

Case Discussion

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.

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