Nazarinia Mohammadali, Esmaeilzadeh Elmira
Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Internal Medicine, Division of Rheumatology, Shiraz University of Medical Sciences, Shiraz, Iran.
Curr Rheumatol Rev. 2019;15(1):79-81. doi: 10.2174/1573397114666180423104410.
Gauzoma is an iatrogenic complication which occurs rarely due to surgical team negligence. Depending on the sterility of the retained tissue, it can lead to life threatening surgical complications or may remain asymptomatic for many years and be detected incidentally in imaging studies. It may be mistaken as tumors or aneurysms. Thus, high clinical suspicion is needed to diagnose them in patients with past history of operation. Reporting Case: A 35 years old woman, a known case of scleroderma underwent open-heart surgery 20 years before being diagnosed as scleroderma, presented by dyspnea especially on activity. The High Resolution CT (HRCT) for evaluating the interestial lung disease was done which detected a 7 cm (in greatest diameter) inflammatory mass in posterior aspect of left hemi thorax with a radiopaque thread in its center. True cut biopsy was done and sent for pathology, which revealed fragments of foreign body materials probably gauze pad fibers with cell debris and blood.
Here, we highlighted the details in clinical history, CT findings, and pathology report of gauzoma in thorax of a scleroderma patient following previous open-heart surgery. It can be guidance for clinician to consider this diagnosis in patients with past history of operation.
纱布瘤是一种医源性并发症，因手术团队疏忽而很少发生。根据残留组织的无菌状态，它可导致危及生命的手术并发症，或可能多年无症状，在影像学检查中偶然发现。它可能被误诊为肿瘤或动脉瘤。因此，对于有手术史的患者，需要高度的临床怀疑才能诊断出该病。病例报告：一名35岁女性，在被诊断为硬皮病20年前曾接受心脏直视手术，此次因呼吸困难就诊，尤其是活动时。进行了高分辨率CT（HRCT）以评估间质性肺病，结果在左半胸后部发现一个直径最大为7厘米的炎性肿块，其中心有一条不透射线的线。进行了切取活检并送去做病理检查，结果显示异物材料碎片，可能是纱布垫纤维，伴有细胞碎片和血液。
在此，我们强调了一名硬皮病患者在先前心脏直视手术后胸部纱布瘤的临床病史、CT表现和病理报告细节。这可为临床医生在有手术史的患者中考虑该诊断提供指导。
