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棉籽屑瘤(残留手术海绵)致既往乳腺手术后感染性休克:一例报告

Gossypiboma (retained surgical sponge) induces septic shock after previous breast surgery: A case report.

作者信息

Shih Pin-Keng

机构信息

Division of Plastic & Reconstructive Surgery, China Medical University Hospital.

China Medical University, Taichung.

出版信息

SAGE Open Med Case Rep. 2019 Feb 13;7:2050313X19830474. doi: 10.1177/2050313X19830474. eCollection 2019.

Abstract

Foreign body granuloma caused by retained surgical sponge is also called gossypiboma or textiloma, is mostly described in the abdominal cavity, with only a very few cases of retained surgical sponges located in breasts. A 48-year-old female came to our emergency department due to shortness of breath with consciousness disturbance. Sixteen years previously, she had gone through modified radical mastectomy. Eight years later, she received breast reconstruction. At emergency department, her hemodynamic status was unstable. Besides, there was one mass lesion with abscess in the right axillary region, and percutaneous abscess drainage was performed. She was sent to the medical intensive care unit for further care of septic shock. Because her symptoms and signs did not improve, we decided to perform fasciectomy and surprisingly found one retained surgical sponge in her breast. After the operation, she recovered well and the wound was stable. Due to limited literature available, we present a case of gossypiboma in the breast with a clinical manifestation of septic shock.

摘要

因手术海绵残留引起的异物肉芽肿也称为医用棉瘤或纺织瘤,多见于腹腔,仅有极少数手术海绵残留于乳房的病例报道。一名48岁女性因呼吸急促伴意识障碍前来我院急诊科就诊。16年前,她接受了改良根治性乳房切除术。8年后,她接受了乳房重建手术。在急诊科时,她的血流动力学状态不稳定。此外,右侧腋窝区域有一个伴有脓肿的肿块病变,遂行经皮脓肿引流术。她被送往医疗重症监护病房进一步治疗感染性休克。由于她的症状和体征没有改善,我们决定进行筋膜切除术,结果令人惊讶地在她的乳房中发现了一块残留的手术海绵。术后,她恢复良好,伤口稳定。鉴于现有文献有限,我们报告一例表现为感染性休克的乳房医用棉瘤病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8442/6378425/6b560b4c8642/10.1177_2050313X19830474-fig1.jpg

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