Presentation
Abdominal pain and vomiting. Hysterectomy for uterine fibroids 3 weeks ago.
Patient Data
Multiple air-fluid levels in the center of the upper abdomen suggestive of small bowel obstruction.
A wavy hyperdense tape-like density is seen in the left side of the pelvis.
Dilated fluid-filled small bowel loops are seen mainly in the center of the abdomen, in keeping with small bowel obstruction.
An irregular area with mottled air appearance and peripheral dense material is seen under anterior abdominal wall in left para-umbilical region, consistent with retained lap sponge.
Minimal free fluid is seen in the pelvis.
Case Discussion
Laparoscopic extraction of the missed lap sponge was done.
Gossypiboma usually has a radio-opaque marker that makes it easily identified on X-ray. CT is the gold standard for the diagnosis and identifies relation to surrounding anatomical structures as well as possible complications.
Gossypiboma typically presents with nonspecific clinical features and can rarely lead to serious clinical consequences like ileus, abscess, fistula, and bowel necrosis. Extraluminal mechanical small bowel obstruction is one of these rare presentations 1.
Unable to process the form. Check for errors and try again.