Jehanzeb Sofia, Khan Bashir, Salman Saad, Khan Aurangzeb, Ali Babar, Shah Muhammad Haseeb, Noureen Sumaira
Department of General Surgery, Mardan Medical Complex, Mardan, PAK.
Department of Radiology, Mardan Medical Complex, Mardan, PAK.
Cureus. 2025 Jun 20;17(6):e86449. doi: 10.7759/cureus.86449. eCollection 2025 Jun.
Gossypiboma refers to the retention of a surgical sponge or pack in a patient's body, postoperatively, with its occurrence most commonly seen intra-abdominally. It is rare but can lead to serious complications if not treated. It can manifest immediately after surgery or can take several years. Clinical presentation can vary from abdominal symptoms to abscess and sepsis. Its diagnosis can be confirmed via radiological modalities such as computed tomography (CT), plain X-ray, ultrasound, and magnetic resonance imaging, with CT being the gold standard. Once confirmed, it should be removed via open or laparoscopic surgery. We present a case of a 35-year-old patient with no known comorbidities who presented to our surgical department with abdominal pain and vomiting, but was vitally stable. Symptoms were persistent with no response to medications. It was found that she had an open cholecystectomy done five months back. CT confirmed the presence of gossypiboma that had eroded the stomach wall and had completely migrated to the stomach, following which an open surgery was performed, and a Promed pack was retrieved from the stomach. Gossypiboma is a rarely reported error, but it can be a life-threatening complication of surgery. The most common site of occurrence is the abdominal cavity; other sites include the breast, thorax, and central nervous system. It is most commonly associated with cholecystectomy and is most often found in the subhepatic region; however, it can erode the surrounding viscera and migrate to other organs, as seen in our case. Various radiological modalities such as CT, ultrasound, and magnetic resonance imaging can be used to confirm the diagnosis. As gossypiboma is a serious complication, all measures should be taken to prevent it, as its incidence depends on surgical practices. Proper pack counts, using radio-opaque products, and adherence to standard safety protocols can play a vital role in its prevention. Early diagnosis and treatment can prevent this complication and improve patient outcomes.
医用海绵瘤是指术后手术海绵或敷料遗留在患者体内，最常见于腹腔内。这种情况很少见，但如果不治疗可能会导致严重并发症。它可在手术后立即出现，也可能需要数年时间。临床表现从腹部症状到脓肿和败血症不等。其诊断可通过计算机断层扫描（CT）、普通X线、超声和磁共振成像等放射学检查手段来确认，其中CT是金标准。一旦确诊，应通过开放手术或腹腔镜手术取出。我们报告一例35岁患者，无已知合并症，因腹痛和呕吐到我院外科就诊，但生命体征稳定。症状持续存在，对药物治疗无反应。发现她五个月前做过开腹胆囊切除术。CT证实存在医用海绵瘤，该瘤已侵蚀胃壁并完全迁移至胃内，随后进行了开放手术，从胃中取出了一块普罗梅德敷料。医用海绵瘤是一种很少被报道的失误，但它可能是手术的危及生命的并发症。最常见的发生部位是腹腔；其他部位包括乳房、胸部和中枢神经系统。它最常与胆囊切除术相关，最常发现于肝下区域；然而，它可侵蚀周围脏器并迁移至其他器官，如我们的病例所示。CT、超声和磁共振成像等各种放射学检查手段可用于确诊。由于医用海绵瘤是一种严重并发症，应采取一切措施预防，因为其发生率取决于手术操作。正确的敷料清点、使用不透射线的产品以及遵守标准安全协议在预防中可发挥重要作用。早期诊断和治疗可预防这种并发症并改善患者预后。
