Abstract
The term gossypiboma is used to describe a retained surgical sponge after operation. It is a rare but serious complication which is seldom reported because of the medicolegal implications. Gossypiboma usually has varied and vague presentation and is also difficult to detect on radiological investigations. It can even remain silent and present years after the operation. We report a case of a 38-year-old lady who presented with vague pain and chronic lump in the right iliac fossa region. She had a history of cesarean section 4 years ago. Radiological investigations were inconclusive in detecting the retained sponge. A working diagnosis of mesenteric cyst was made and an exploratory laparotomy was done where she was found to have a large gossypiboma densely adhered to the small bowel and surrounding structures. Though rare, gossypiboma should be kept in mind as a differential diagnosis in postoperative cases presenting as vague pain or chronic lump even years after the operation.
Highlights
The term gossypiboma is used to describe a surgical sponge or a laparotomy pad left involuntarily in the body after a surgical procedure
Most gossypiboma cases are discovered during the first few days after surgery; they may remain undetected for many years [2]
The patient underwent an ultrasound and a CECT abdomen (Figure 1) before consulting us. Both these tests revealed a well-defined lump in relation to the small bowel in the right iliac fossa region suggestive of mesenteric cyst
Summary
The term gossypiboma is used to describe a surgical sponge or a laparotomy pad left involuntarily in the body after a surgical procedure. The term is derived from a combination of Latin words “Gossypium” (cotton) and Swahili word “boma” (place of concealment) [1]. It is a rare surgical complication but can cause significant morbidity and mortality. Most gossypiboma cases are discovered during the first few days after surgery; they may remain undetected for many years [2]. Imaging modalities including plain radiography, ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) may help to have exact diagnosis [3]. Surgery is the recommended treatment option in these cases. Gossypiboma should be considered as a diagnosis in patients with intra-abdominal mass with previous history of surgery
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