Gossypiboma: A clinical vignette and summary of radiologic characteristics

Abstract

Gossypibomas are rare in modern surgery; however, present a significant medico-legal dilemma when they do arise. Treatment is surgical retrieval after identification. When seen years after the original procedure, a diagnostic dilemma arises. Diagnosis via radiologic means is often unreliable, thus, diagnosis involves excision or core needle biopsy. In this unique case, we were forced to make a diagnosis without tissue confirmation due to patient request. Gossypibomas have been described as having highly variable appearance on computed tomography, and thus, radiologic diagnosis is considered unreliable. Often, the characteristic spongiform appearance typically used to describe chronic gossypibomas is not observed. In our case, matching the radiodensity of surgical gauze with that of the gossypiboma helped to make a correct diagnosis, suggesting that radiologic diagnosis is possible in certain cases. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice based learning and improvement, Systems based practice.