A Case Study on Gossypiboma: Identifying a Hidden Surgical Adversary

Abstract

Gossypiboma is a rare but dangerous surgical complication that can be explained as a retained foreign body mass of cotton (sponge, abdominal mop or gauze) within the body following a surgical treatment. According to estimates, retained surgical items occur in 1 in 5500 to 1 in 18,000 surgical procedures, making them a rare complication. Owing to its serious medicolegal implications it remains underreported leading to a blurred clinical spectrum. This fact is also depicted in our case which presents an array of nonspecific symptoms painting a picture of possible malignancy.

Wilson documented the first retained foreign body following a laparotomy in 1884. The case study focuses on a young fertile woman who had subtotal hysterectomy with bilateral internal iliac ligation in a tertiary care hospital. Following the procedure, she experienced acute abdominal pain because of a retained abdominal mop. The abdominal mop moved transmurally and became lodged in the ileocolic junction. Following the removal of the intra-luminal abdominal mop and abdominal closure, she experienced uneventful post-operative time period.

This case emphasizes the need of following surgical standards and how even tiny mistakes can have serious consequences. This demonstrates the necessity of combining technology and medicine, leading to the adoption of innovations like electronic counting and sponges with Radio-Frequency Identification (RFID) tags to reduce human error.