EXTRACTION OF ABDOMINAL GOSSYPIBOMA: CASE REPORT
Abstract
Introduction: A surgical sponge or compress retained in a patient after surgery or “gossypiboma” constitutes an uncommon but preventable surgical error. This adverse event has a great impact on morbidity and mortality, as well as medical-legal repercussions.
Case description: A 33-year-old patient, with a history of exploratory laparotomy for ectopic pregnancy 2 years ago, surgical sterilization four months later and liposuction 5 days ago, presents with continuous moderate to high intensity abdominal pain in the right iliac fossa and a sensation of bulge in the abdomen. The physical examination revealed an asymmetric abdomen, a hard palpable mass of approximately 7 cm x 6 cm, very painful in the right iliac fossa and partially mobile. Simple and contrast-enhanced tomography of the abdomen and pelvis showed a foreign body in the right iliac fossa. An exploratory laparotomy was performed and a retained surgical compress was removed, which confirmed the diagnosis of gossypiboma.
Conclusion: Gossypiboma is a postoperative complication that presents great clinical variability. In patients who present a palpable abdominal mass and a surgical history, a gossypiboma should be considered part of the differential diagnosis. The surgical team must take all precautions to prevent this serious error.
References
2. Items Commonly Retained After a Surgical Procedure. AORN J [Internet]. mayo de 2022 [citado 8 de marzo de 2024];115(5). Disponible en: https://aornjournal.onlinelibrary.wiley.com/doi/10.1002/aorn.13685
3. Copeland, Annesley. Retained surgical sponge (gossypiboma) and other retained surgical items: Prevention and management. UpToDate. 2024;
4. Hibbert PD, Thomas MJW, Deakin A, Runciman WB, Carson-Stevens A, Braithwaite J. A qualitative content analysis of retained surgical items: learning from root cause analysis investigations. Int J Qual Health Care. 20 de mayo de 2020;32(3):184-9.
5. Styskel B, Wernick B, Mubang R, Falowski S, Papadimos T, Stawicki S. Retained surgical items: Building on cumulative experience. Int J Acad Med. 2016;2(1):5.
6. Wan W, Le T, Riskin L, Macario A. Improving safety in the operating room: a systematic literature review of retained surgical sponges. Curr Opin Anaesthesiol. abril de 2009;22(2):207-14.
7. Ca G, Cs J, Lopes Ct DA, Kvt DS, Nascimento R DO, Add R, et al. Intra-abdominal gossypiboma: Still a severe postoperative complication. Trauma Emerg Care [Internet]. 2017 [citado 30 de marzo de 2024];3(1). Disponible en: http://www.oatext.com/intra-abdominal-gossypiboma-still-a-severe-postoperative-complication.php
8. Kumar P, Shukla P, Tiwary SK, Verma A, Khanna AK. Gossypiboma: An avoidable but not a rare complication. Proc Singap Healthc. diciembre de 2021;30(4):330-3.
9. Sonarkar R, Wilkinson R, Nazar Z, Gajendra G, Sonawane S. Textiloma presenting as a lump in abdomen: A case report. Int J Surg Case Rep. 2020;77:206-9.
10.Patial T, Rathore N, Thakur A, Thakur D, Sharma K. Transmigration of a retained surgical sponge: a case report. Patient Saf Surg. diciembre de 2018;12(1):21.
11.Patial T, Thakur V, Vijhay Ganesun N, Sharma M. Gossypibomas in India - A systematic literature review. J Postgrad Med. 2017;63(1):36-41.
12.Bairwa BL. Gossypiboma-an unusual cause of surgical abdomen and surgeon’s nightmare: A rare case report. Int J Surg Case Rep. marzo de 2021;80:105521.
13. Maldonado Schoijet I, Charaf Muñoz Y, Nicolai Manaut J, Schiappacasse Faúndes G, Varela Ubilla C. Textiloma abdominal: Actualización y aporte al diagnóstico desde las imágenes. Rev Cir [Internet]. 1 de octubre de 2022 [citado 27 de marzo de 2024];74(5). Disponible en: https://www.revistacirugia.cl/index.php/revistacirugia/article/view/1520
14.WHO Patient Safety, World Health Organization. WHO guidelines for safe surgery 2009: safe surgery saves lives. Safe Surg Saves Lives. 2009;(WHO/IER/PSP/2008.08-1E):124.
15. Cochran K. Guidelines in Practice: Prevention of Unintentionally Retained Surgical Items. AORN J. noviembre de 2022;116(5):427-40.
16.American College of Surgeons. Revised Statement on the Prevention of Unintentionally Retained Surgical Items After Surgery [Internet]. American College of Surgeons. [citado 1 de abril de 2024]. Disponible en: https://www.facs.org/about-acs/statements/prevention-of-unintentionally-retained-surgical-items-after-surgery/
Copyright (c) 2024 REFLECTIONS. Scientific journal of Eugenio Espejo Hospital
This work is licensed under a Creative Commons Attribution 4.0 International License.
