de Gea Rico Aitor, Krishna Priya, Devlin Hannah Louise, Rohatgi Ashish
General Surgery Department, Whipps Cross University Hospital, London, UK.
BMJ Case Rep. 2018 Sep 26;2018:bcr-2017-221537. doi: 10.1136/bcr-2017-221537.
A gossypiboma is a mass within a patient's body comprising a cotton matrix surrounded by a foreign body granuloma. We describe an unusual presentation of a gossypiboma presenting in a 32-year-old man with acute epigastric pain and haematemesis. His surgical history revealed an emergency laparotomy following a road traffic accident 16 years ago. Initial gastroscopy showed extrinsic stomach compression. An abdominal ultrasound scan followed by a CT scan evidenced a large, well-defined, predominantly cystic mass with some solid areas occupying the left hypochondrium. Conservative management with insertion of a percutaneous drain proved to be inefficient. A laparotomy was performed; intraoperatively, the cyst was found to be ruptured and within it, a large surgical gauze was found. This was removed but required a distal pancreatectomy and gastrectomy for complete excision. He was discharged on day 74 of admission with outpatient follow-up.
棉籽瘤是患者体内的一种肿块，由异物肉芽肿包裹的棉花基质组成。我们描述了一名32岁男性棉籽瘤的不寻常表现，该患者伴有急性上腹部疼痛和呕血。他的手术史显示，16年前曾因道路交通事故接受过急诊剖腹手术。初次胃镜检查显示胃受到外部压迫。随后进行的腹部超声扫描及CT扫描证实，左季肋部有一个边界清晰、主要为囊性且伴有一些实性区域的大肿块。经皮引流保守治疗无效。遂进行剖腹手术；术中发现囊肿破裂，在囊肿内发现一块大的手术纱布。纱布被取出，但为完全切除需行远端胰腺切除术和胃切除术。患者在入院第74天出院，并安排了门诊随访。
