Abstract
Intrathoracic gossypiboma are exceptional, but diagnosis and treatment are difficult. The purpose of this study was to recall the clinical and radiological aspects of intrathoracic gosssyibomas and discuss the medicolegal consequences. From January 1990 to June 2003, eight cases of gossypiboma were treated in our unit. The patients were aged 31 to 60 years (mean 40.5). Six had a history of thoracic surgery and two a history of biliary surgery. Clinically, the main symptom was hemoptysia (7 patients, 87.5%). Four patients (50%) presented thoracic pain and one a pleurocutaneous fistula. The chest x-ray revealed a poorly delimited opacity in six patients, a liquid effusion in one and a raised left diaphragm in one. The thoracic scan performed in two patients demonstrated an air image in one and a liquid image in the other. Surgical removal was difficult in all eight patients. Pulmonary parenchyma had to be sacrificed in certain patients. Two patients developed postoperative complications (one pneumothora and one thoracic wall infection). The diagnosis of intrathoracic gossypiboma should be suggested in all patients with a pulmonary mass and a history of thoracic surgery, more rarely laparotomy. Prevention remains the best treatment.
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