Gossypiboma – A Rare Cause of Palpable Intra-Abdominal Mass: A Case Report

Abstract

Introduction

Gossypiboma is the accidental retention of surgical gauze with inflammatory reaction in the body cavity after surgical procedures. It is an uncommon but preventable surgical mistake. This serious medical condition could have a substantial impact on morbidity and mortality as well as medico-legal issues.

Case Report

We present here a case of a 30-year-old female referred to our surgical outpatient department with progressive lower abdominal swelling, pain, and low-grade fever of 4 months' duration after she had undergone cesarean section 6 months back at the primary hospital. On physical examination, she was tachycardic and had a 15×15 cm firm, mobile, non-tender, infra-umbilical abdominal mass. Abdominal ultrasound suggested possible gossypiboma, which was confirmed after exploratory laparotomy.

Discussion

Any type of surgery can be a reason for retained surgical gauze, but its incidence can be significantly reduced if surgical checklists are used seriously and routinely in every patient. A strong index of suspicion continues to be crucial in the diagnosis of surgical gauze retention, particularly when a patient has experienced an unexplained bad course following surgery.

Conclusion: 

In patients who present with palpable abdominal mass and a history of previous abdominal surgical operations, the diagnosis of gossypiboma should be included in the differential diagnosis. Prevention of retained surgical items is the collective responsibility of the surgical team, the nursing team, and operation theatre technicians. Furthermore, strict measures should be implemented to avoid it.

Keywords:

• case report
• gossypiboma
• retained foreign body
• abdominal sponge
• abdominal mass

Ethical Approval

The ethical approval was exempted as case reports do not require it.

Consent

Informed written consent was obtained from the patient for publication of this case report and accompanying images.

Disclosure

Authors do not have any conflicts of interest.

Additional information

Funding

All authors have declared that no financial support or funding was received from any organization and have no financial relationships at present or within the past three years with any organizations that might have an interest in the submitted work.