An unusual cause of small bowel obstruction: Gossypiboma – case reportReport as inadecuate

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BMC Surgery

, 3:6

First Online: 08 September 2003Received: 30 April 2003Accepted: 08 September 2003


BackgroundThe term -gossypiboma- denotes a mass of cotton that is retained in the body following surgery. Gossypiboma is a medico-legal problem especially for surgeons. To the best of our knowledge, the patient presented herein is the second reported patient in whom the exact site of migration of a retained surgical textile material into the intestinal lumen could be demonstrated by preoperative imaging studies.

Case presentationA 74-year-old woman presented with symptoms of small bowel obstruction due to incomplete intraluminal migration of a laparotomy towel 3 years after open cholecystectomy and umbilical hernia repair. Plain abdominal radiography did not show any sign of a radio-opaque marker in the abdomen. However, contrast enhanced abdominal computerized tomography revealed a round, well-defined soft-tissue mass with a dense, enhanced wall, containing an internal high-density area with air-bubbles in the mid-abdomen. A fistula between the abscess cavity containing the suspicious mass and gastrointestinal tract was identified by upper gastrointestinal series. The presence of a foreign body was considered. It was surgically removed with a partial small bowel resection followed by anastomosis.

ConclusionsAlthough gossypiboma is rarely seen in daily clinical practice, it should be considered in the differential diagnosis of acute mechanical intestinal obstruction in patients who underwent laparotomy previously. The best approach in the prevention of this condition can be achieved by meticulous count of surgical materials in addition to thorough exploration of surgical site at the conclusion of operations and also by routine use of surgical textile materials impregnated with a radio-opaque marker.

Keywordsgossypiboma foreign bodies retained surgical towel intestinal obstruction radiography CT List of abbreviations usedUSGultrasonography

CTcomputerized tomography

MRImagnetic resonance imaging

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2482-3-6 contains supplementary material, which is available to authorized users.

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Author: Rasim Gencosmanoglu - Resit Inceoglu


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