Abdullah Lava, Alsulaiman Sihaam Saleh, Imran Muhammad, Barakat Rafe, Rustum Osama
Department of Obstetrics and Gynecology.
University College of Medicine and Dentistry, University of Lahore, Lahore, Pakistan.
Ann Med Surg (Lond). 2023 Sep 5;85(11):5675-5678. doi: 10.1097/MS9.0000000000001275. eCollection 2023 Nov.
Retained surgical items are an uncommon complication for surgical operations, with an estimated incidence of 1 in 5500 to 1 in 18 000 operations. Retained surgical sponges are the most common retained surgical items, accounting for nearly 70%. In 1884, Wilson reported the first retained foreign body after laparotomy.
A 22-year-old woman was referred to our hospital complaining of a feeling of abdominal bloating and heaviness associated with pain, fever, fatigue, and severe stink vaginal discharges. Past surgical history included a cesarean section followed by laparotomy to remove a foreign body left behind; the obstetrician denied the presence of any foreign body. The diagnosis of retained surgical sponges was done in our hospital, according to the clinical history and radiographic study. The second laparotomy was performed, and the surgical sponge was removed.
Retained surgical items' symptoms vary according to the site and types of materials. The diagnosis may be difficult because it resembles benign or malignant soft-tissue tumors of the abdomen and pelvis. Ultrasound and computed tomography have been used for the diagnosis of retained surgical items. The minimally invasive surgical approach appears to be most successful if the object is located early in the postoperative course.
Retained surgical items are serious problems of surgical operations and should be among the differential diagnosis of any abdominal pain in patients with a history of prior surgery.
手术中遗留物品是手术操作中一种不常见的并发症，估计发生率为每5500至18000例手术中有1例。手术中遗留的海绵是最常见的手术中遗留物品，占近70%。1884年，威尔逊报告了首例剖腹手术后遗留异物的病例。
一名22岁女性因腹胀、沉重感伴疼痛、发热、疲劳及严重恶臭的阴道分泌物被转诊至我院。既往手术史包括剖宫产，随后行剖腹手术以取出遗留的异物；产科医生否认有任何异物存在。根据临床病史和影像学检查，我院诊断为手术中遗留海绵。遂进行了第二次剖腹手术，取出了手术海绵。
手术中遗留物品的症状因部位和材料类型而异。其诊断可能较为困难，因为它类似于腹部和盆腔的良性或恶性软组织肿瘤。超声和计算机断层扫描已用于手术中遗留物品的诊断。如果在术后早期发现异物，微创外科手术方法似乎最为成功。
手术中遗留物品是手术操作中的严重问题，对于有既往手术史的腹痛患者，应将其列入鉴别诊断范围。
