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空肠棉籽瘤酷似胃肠道间质瘤:一例罕见的医源性并发症及文献复习

Jejunal Gossypiboma Mimicking a Gastrointestinal Stromal Tumor: A Case of a Rare Iatrogenic Complication and Review of the Literature.

作者信息

Papaoikonomou Michail Angelos, Michailidou Europi, Pogiatzis Christos, Michailidi Maria Eleni, Panselinas Gregorios

机构信息

Department of General Surgery, General Hospital of Thessaloniki Agios Pavlos, Thessaloniki, GRC.

Department of Pathology, General Hospital of Thessaloniki Agios Pavlos, Thessaloniki, GRC.

出版信息

Cureus. 2024 Dec 13;16(12):e75651. doi: 10.7759/cureus.75651. eCollection 2024 Dec.

DOI:10.7759/cureus.75651
PMID:39803147
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11725300/
Abstract

The term "gossypiboma" or "textiloma" is used to describe a mass of retained cotton matrix and the surrounding inflammatory response inside a body cavity following surgical intervention. The precise incidence of this phenomenon is uncertain, as cases are frequently underreported due to concerns related to medical malpractice. This rare complication poses a diagnostic dilemma due to the non-specific clinical and radiological features, which can result in significant morbidity and mortality. While diagnosis of this condition has been reported through various imaging modalities such as abdominal ultrasound and computed tomography, there are instances where cases do not present with typical findings, which can make it tough to make a preoperative diagnosis. The differential diagnosis from submucosal tumors of the gastrointestinal tract becomes challenging, particularly when the tumors are in contact with the gastrointestinal tract. It is possible that patients may be incorrectly informed that masses may be malignant, which could result in unnecessary extirpative surgery. In some cases, the diagnosis is discovered postoperatively. This case report presents a case of a 42-year-old woman who was initially suspected of having a gastrointestinal stromal tumor based on radiological findings. However, the patient was ultimately diagnosed with a gossypiboma following surgical intervention. A gross examination of the surgical specimen revealed that a gauze left over from a cesarean section performed nearly 20 years ago was the source of the gossypiboma. It is therefore evident that meticulous counting of surgical instruments and materials is crucial for patient safety and optimal outcomes.

摘要

术语“棉绒瘤”或“纺织瘤”用于描述手术干预后体腔内残留的棉花基质团块及周围的炎症反应。由于担心医疗事故,此类病例经常报告不足,因此这种现象的确切发生率尚不确定。这种罕见的并发症由于临床和放射学特征不具特异性,会造成诊断难题,进而可能导致严重的发病和死亡情况。虽然已通过腹部超声和计算机断层扫描等各种成像方式诊断出这种病症,但有些病例并无典型表现,这使得术前诊断变得困难。与胃肠道黏膜下肿瘤的鉴别诊断颇具挑战性,尤其是当肿瘤与胃肠道接触时。患者可能会被错误告知肿块可能是恶性的,这可能导致不必要的切除手术。在某些情况下,诊断是在术后发现的。本病例报告介绍了一名42岁女性的病例,该患者最初根据放射学检查结果被怀疑患有胃肠道间质瘤。然而,患者在手术干预后最终被诊断为棉绒瘤。对手术标本的大体检查显示,近20年前剖宫产手术遗留的一块纱布是棉绒瘤的根源。因此,显然仔细清点手术器械和材料对患者安全及实现最佳治疗效果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6a7/11725300/1330a15e29f6/cureus-0016-00000075651-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6a7/11725300/f7cc45a98b49/cureus-0016-00000075651-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6a7/11725300/4bae5390a5d6/cureus-0016-00000075651-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6a7/11725300/cc5893782f2d/cureus-0016-00000075651-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6a7/11725300/cdae86a1dced/cureus-0016-00000075651-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6a7/11725300/1330a15e29f6/cureus-0016-00000075651-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6a7/11725300/f7cc45a98b49/cureus-0016-00000075651-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6a7/11725300/4bae5390a5d6/cureus-0016-00000075651-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6a7/11725300/cc5893782f2d/cureus-0016-00000075651-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6a7/11725300/cdae86a1dced/cureus-0016-00000075651-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6a7/11725300/1330a15e29f6/cureus-0016-00000075651-i05.jpg

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Jejunal Gossypiboma Mimicking a Gastrointestinal Stromal Tumor: A Case of a Rare Iatrogenic Complication and Review of the Literature.空肠棉籽瘤酷似胃肠道间质瘤:一例罕见的医源性并发症及文献复习
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本文引用的文献

1
A case of intra-abdominal textiloma mimicking a mesenteric tumor.一例酷似肠系膜肿瘤的腹腔内纺织瘤病例。
Int J Surg Case Rep. 2024 Nov;124:110370. doi: 10.1016/j.ijscr.2024.110370. Epub 2024 Sep 30.
2
A case of intra-abdominal gossypiboma diagnosed preoperatively by endoscopic ultrasound fine-needle-aspiration.1例术前经内镜超声细针穿刺诊断的腹腔内棉籽瘤。
DEN Open. 2024 May 29;5(1):e388. doi: 10.1002/deo2.388. eCollection 2025 Apr.
3
Case Report: Laparoscopy-assisted resection for intra-abdominal gossypiboma masquerading as a jejunal tumor (with video).
病例报告:腹腔镜辅助切除伪装为空肠肿瘤的腹腔内棉球瘤(附视频)
Front Oncol. 2023 Nov 28;13:1326032. doi: 10.3389/fonc.2023.1326032. eCollection 2023.
4
Upper gastrointestinal tract obstruction caused by a gossypiboma: A rare surgical case report.棉籽瘤导致的上消化道梗阻:一例罕见的外科病例报告。
Int J Surg Case Rep. 2023 Dec;113:109067. doi: 10.1016/j.ijscr.2023.109067. Epub 2023 Nov 17.
5
Gossypiboma left behind in a cesarean section ended up with a failed laparotomic excision, which demanded another laparotomy to remove it: a rare case report.剖宫产术中遗留的棉球瘤最终导致剖腹切除失败,需再次剖腹手术将其取出:一例罕见病例报告
Ann Med Surg (Lond). 2023 Sep 5;85(11):5675-5678. doi: 10.1097/MS9.0000000000001275. eCollection 2023 Nov.
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Retained surgical item (Gossypiboma): a case report and literature review.手术遗留物(棉球瘤):一例病例报告及文献综述
Ann Med Surg (Lond). 2023 Jun 17;85(7):3717-3721. doi: 10.1097/MS9.0000000000000992. eCollection 2023 Jul.
7
Novel Computer-Aided Diagnosis Software for the Prevention of Retained Surgical Items.新型计算机辅助诊断软件预防手术器械遗留
J Am Coll Surg. 2021 Dec;233(6):686-696. doi: 10.1016/j.jamcollsurg.2021.08.689. Epub 2021 Sep 27.
8
Giant gossypiboma presenting as a pelvic mass.表现为盆腔肿块的巨大棉籽瘤。
Radiol Case Rep. 2021 Aug 26;16(11):3308-3310. doi: 10.1016/j.radcr.2021.07.075. eCollection 2021 Nov.
9
A gossypiboma masquerading as a mesenteric cyst.一个棉织物异物伪装成肠系膜囊肿。
Malawi Med J. 2021 Mar;33(1):68-70. doi: 10.4314/mmj.v33i1.11.
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Presentation and surgical management of a gossypiboma presenting with small bowel obstruction.棉织物残留(gossypiboma)致小肠梗阻的临床表现和手术治疗。
Clin J Gastroenterol. 2021 Aug;14(4):1067-1070. doi: 10.1007/s12328-021-01400-y. Epub 2021 Mar 31.