Migratory surgical Gossypiboma-Cause of iatrogenic perforation: Case report with review of literature

Abstract

Forgotten foreign bodies, such as cotton sponges, gauze, or instruments, after any surgical procedure is considered a misadventure but avoidable complication. "Gossypiboma" denotes a mass of cotton that is accidentally retained in the body postoperatively. This study′s goal was to systematically review the literature on retained sponges to identify incidence, site of occurrence, time of discovery, methods for detection, pathogenesis for intraluminal migration and risk factors. Author is reporting this case in which a 45-year old woman presented with features of chronic pain abdomen following abdominal hysterectomy (first surgery) which lead to open cholecystectomy (second surgery) after two and half year of first surgery. As patients continued to have persistent abdominal pain in spite of second surgery patient went to medical gastroenterologist who advised her series of tests including colonoscopy examination. The whole colon was normal on examination but on examination of terminal portion of small bowel some intraluminal mass was visualized. Attempt to retrieve this mass lead to iatrogenic ileal perforation.

Keywords

• Gossypiboma
• iatrogenic
• ileal perforation
• intraluminal migration