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腹腔镜成功切除棉绒瘤:一例报告。

Successful laparoscopic removal of gossypiboma: A case report.

作者信息

Soori Mohsen, Shadidi-Asil Rouzbeh, Kialashaki Mehrnoosh, Zamani Amir, Ebrahimian Manoochehr

机构信息

Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of General Surgery, Shafa Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.

出版信息

Int J Surg Case Rep. 2022 Feb;91:106799. doi: 10.1016/j.ijscr.2022.106799. Epub 2022 Jan 26.

Abstract

INTRODUCTION AND IMPORTANCE

Gossypiboma is defined as developing an exudative inflammatory process around retained foreign bodies (RFBs). This problem may be asymptomatic or present with severe systemic or regional symptoms. Traditionally, every RFB must be removed with a surgical procedure. In the era of minimally invasive surgery, laparoscopic removal is a good choice for these problems.

CASE PRESENTATION

A young woman was referred to us with intermittent vague abdominal pain and a history of open cholecystectomy. After initial imaging, we found a twisted string-like object in epigastrium. Considering clinical findings and imaging, the patient was taken to the operating room with a diagnosis of RFB. After an explorative laparoscopy, we found an encapsulated fibrotic mass around a surgical sponge with pus-like secretions.

CONCLUSION

After diagnosing either RFB or gossypiboma, surgical intervention is mandatory, even in asymptomatic patients. Laparoscopy can help the surgeon to remove the retained item safely. Also, decreased length of stay and postoperative pain are significant advantages of laparoscopic removal.

摘要

引言与重要性

棉籽瘤被定义为在残留异物(RFBs)周围发生渗出性炎症过程。这个问题可能无症状,也可能表现为严重的全身或局部症状。传统上,每个RFB都必须通过外科手术取出。在微创手术时代,腹腔镜取出术是解决这些问题的一个不错选择。

病例介绍

一名年轻女性因间歇性模糊腹痛和开腹胆囊切除术病史被转诊至我院。初步影像学检查后,我们在上腹部发现一个扭曲的绳状物体。结合临床检查结果和影像学表现,该患者被诊断为RFB并送入手术室。经过探索性腹腔镜检查,我们发现一块手术海绵周围有一个包裹性纤维化肿块,伴有脓性分泌物。

结论

在诊断出RFB或棉籽瘤后,即使是无症状患者也必须进行手术干预。腹腔镜检查有助于外科医生安全地取出残留物品。此外,缩短住院时间和减轻术后疼痛是腹腔镜取出术的显著优点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69d9/8808061/d4904c424174/gr1.jpg

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