Gümüş Metehan, Gümüş Hatice, Kapan Murat, Onder Akn, Tekbaş Güven, Baç Bilsel
Department of General Surgery, Medical Faculty, Dicle University, Diyarbakir, Turkey.
Am J Forensic Med Pathol. 2012 Mar;33(1):54-7. doi: 10.1097/PAF.0b013e31821c09fe.
After surgery, the most common foreign bodies retained in the abdominal cavity are the surgical sponges. The aim of the present study was to emphasize the importance of gossypiboma, which is a serious and medicolegal problem. The records of 12 patients with a confirmed diagnosis of gossypiboma after abdominal surgery at Dicle University Hospital were retrospectively reviewed between January 1994 and December 2009. Eight of the 12 patients were females, and 4 were males. Previously, 7 patients had been operated on electively, and 5 had undergone operations on an emergency basis. Abdominal ultrasonography clearly demonstrated gossypibomas in 5 patients, and computed tomography demonstrated a more precise image of retained surgical sponges in 3 patients. One patient died because of ventricular fibrillation; the other 11 patients were discharged in good health. To eliminate the risk of gossypibomas, all sponges should be counted at least twice (once preoperatively and once postoperatively); use of small sponges should be avoided during laparotomy, and only sponges with radiopaque markers should be used. The surgeon should explore the abdomen before closure. In cases in which the sponge count is uncertain, an abdominal x-ray should be performed before closure.
手术后，腹腔内残留的最常见异物是手术海绵。本研究的目的是强调棉籽瘤的重要性，它是一个严重的医学法律问题。回顾性分析了1994年1月至2009年12月在迪克莱大学医院接受腹部手术后确诊为棉籽瘤的12例患者的记录。12例患者中8例为女性，4例为男性。此前，7例患者接受了择期手术，5例接受了急诊手术。腹部超声在5例患者中清晰显示了棉籽瘤，计算机断层扫描在3例患者中显示了残留手术海绵更精确的图像。1例患者因心室颤动死亡；其他11例患者健康出院。为消除棉籽瘤的风险，所有海绵应至少清点两次（一次术前，一次术后）；剖腹手术期间应避免使用小海绵，应仅使用带有不透射线标记物的海绵。外科医生应在关腹前探查腹腔。在海绵计数不确定的情况下，关腹前应进行腹部X线检查。
