Intrathoracic Gossypiboma: 2 Case Reports and Review of the Literature

Abstract

Intrathoracic gossypiboma (IG) is a sponge inadvertently left in the thoracic cavity during surgery, also referred to as a retained surgical sponge, textiloma, gauzoma, muslinoma or cottonoid. Although gossypibomas are most frequently reported after abdominal surgery, they are occasionally associated with cardiac or pulmonary surgery. Although the actual incidence of IG is not precisely known, its estimated incidence is 1 case per 1,000–10,000 surgeries. Here we report two cases of IG treated in our hospital along with a systematic review of the current literature. The literature review revealed that patients can be misdiagnosed with ailments such as aspergilloma, bronchial carcinoma, bronchiectasis, hydatid cyst, and empyema. The average time from the initial surgery to diagnosis is 6.9 yr (range, 3 wk to 52 yr). The patient often presents with asymptomatic complaints such as cough, pain, vomiting or fever in the early postoperative period. Cases with a history of intrathoracic surgery should be assessed for possible IG in differential diagnosis of new masses. To avoid morbidity, it is very important that sponges used during operations be counted carefully and that radiopaque sponges be used.