Title: Reporting a Clinicoradiological Diagnostic Dilemma: Gossypibioma – A Case Report

Authors: Dr Nithi Doley, Dr Ruby Chattopadhyay

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.140

Abstract

Gossypibioma is a term used to describe a surgical sponge retained at the site of operation and the body’s response to the retained foreign body. Gossypibioma is derived from the words: ‘Gossypium’ which in Latin means cotton and ‘boma’, a swahili word meaning concealment.  It is a surgical mistake which can be avoided if operative theatre records are properly followed.  It is very rarely reported because of the the medicolegal implications and criticism by the mass media. Gossypibioma presents as a clinical and radiological diagnostic dilemma because of its variable and vague clinical presentations particularly in longstanding cases and imaging may mimic intra-abdominal abscess or neoplasm.  Gossypibioma may also present as an intra-abdominal soft tissue swelling or localised pain abdomen particularly following a surgery.  Most of the cases of Gossypibioma are usually detected within few days after surgery, but some may remain undetected for many years.  A case of 27 year old female was referred to our centre with a complaint of abdominal fullness since one year after delivery of her child by caesarean section.  After clinical and radiological correlation a differential diagnosis of Gastrointestinal stromal tumour, Desmoid tumour, Gossypibioma was made.  An exploratory laparotomy was performed, the mass was resected and tissue was sent for histopathological examination to confirm the diagnosis of Gossypibioma.

Keywords: Retained surgical mop, gossypibioma, retained foreign body, post surgery abdominal swelling.

References

  1. G V Santhosh Kumar, Subhash Ramani, Abhishek Mahajan, Nikshita Jain, Rachel Sequeira, and Meenakshi Thakur, “Imaging of retained surgical items: A pictorial review including new innovations”, Indian J Radiol 2017 Jul-Sep; 27(3): 354–361.
  2. Seema Chopra, Vanita Suri, Pooja Sikka, and Neelam Aggarwal, “A Case Series on Gossypiboma - Varied Clinical Presentations and Their Management”, J Clin Diagn Res. 2015 Dec; 9(12): QR01–QR03. Published online 2015 Dec 1. doi:10.7860/JCDR/2015/15927.6978.
  1. Yun-Xiao Lv, Cheng-Chan Yu, Chun-Fang Tung, and Cheng-Chung Wu, “Intractable duodenal ulcer caused by transmural migration of gossypiboma into the duodenum - a case report and literature review”, BMC Surg. 2014; 14: 36. Published online 2014 Jun 10. doi:1186/1471-2482-14-36.
  2. Vamsi Krishna, D Bharath kumar “Intraluminal migration of Gossypibioma”International Journal of Surgery Case Reports. Volume 47, 2018, Pages 61-63.
  3. Sarath Chandra Sistla, Ananthakrishnan Ramesh, Vilvapathy Sengutuvan Karthikeyan et al., “Gossypiboma Presenting as Coloduodenal Fistula – Report of a Rare Case With Review of Literature”,Int Surg. 2014 Mar-Apr; 99(2): 126–131.
  4. Temidayo Og undiran, Omobolaji Ayandipo, Adenike Adeniji-Sofoluwe et al. “Gossypiboma: complete transmural migration of retained surgical sponge causing small bowel obstruction”, BMJ Case Rep. 2011; 2011: bcr0420114073. Published online 2011 Jun 30. doi:10.1136/bcr.04.2011.4073.

Corresponding Author

Dr Nithi Doley

Department of Pathology, INHS Kalyani, Visakhapatnam, Andhra Pradesh – 530005, India