Abstract
To highlight the unusual postoperative clinical presentation of a retained sponge. Recognition of postoperatively retained foreign bodies is essential but often delayed, either because of medicolegal implications or because of a confusing clinical presentation and non-specific imaging features. In contrast to radio-opaque materials which are detected at follow-up imaging, radiolucent objects like sponges create problems in identification. A 30-year-old lady presented with intermittent non-bilious vomiting, epigastric pain and fever. Contrast-enhanced computed tomography of the abdomen showed a heterogeneous mass in the duodenum with multiple air pockets. Surgical exploration revealed a full-size surgical sponge with one end embedded in the gallbladder fossa and the other perforating the antrum of the stomach, thus causing an obstruction. The sponge was retrieved, and distal gastrectomy with Billroth II anastomosis was performed. The postoperative course was uneventful. A high degree of suspicion and awareness of non-specific symptomatology associated with retained sponges after surgery is essential for early diagnosis and correct treatment.
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