Case Report

Unveiling the Hidden Peril: A Rare Case of Gossypiboma in an Elderly Woman

Abstract

Background: Revolutionary developments in the surgical field have led to a comparative reduction in surgeryassociatedcomplications than in the past. However, some complications, which directly indicate surgeon’s negligence, should not be underestimated. Gossypibomas, a rare but horrifying complication of surgeries, occur when cotton foreign bodies are retained in the patient and are only discovered after long periods of time.
Methods: A 46-year-old diabetic anemic female, with a previous history of operative management for cancer of
the cervix (stage IA2), presented with features suggesting sub-acute intestinal obstruction.
Results: Contrast Enhanced Computed Tomography (CECT) of the abdomen revealed a linear hyper- attenuating string-like structure in the distal bowel loop, suggesting a Retained Foreign Body. The patient was immediately taken up for exploratory laparotomy, and the retained foreign body was removed.
Conclusions: Although the diagnosis of Gossypibomas can be challenging at times, it is imperative to manage
patients with this rare complication swiftly and precisely to prevent permanent future disabilities. Young
surgeons should be made aware of the legal consequences of such a dreaded complication and should anticipate the diagnosis in bizarre surgical circumstances.

1. Biswas RS, Ganguly S, Saha ML, Saha S, MukherjeeS, Ayaz A. Gossypiboma and surgeon- current medicolegal aspect - a review. Indian J Surg. 2012 Aug;74(4):318-22. https://doi.org/10.1007/s12262- 012-0446-3. Epub 2012 Mar 27. PMID: 23904722; PMCID: PMC3444596.
2. Lauwers, P., Van Hee, R. Intraperitoneal Gossypibomas: The Need to Count Sponges. World J. Surg. 24, 521-527 (2000).
https://doi.org/10.1007/s002689910084
3. Patial T, Thakur V, Vijhay Ganesun N, Sharma M. Gossypibomas in India - A systematic literature review.J Postgrad Med. 2017 Jan-Mar;63(1):36-41. https://doi.org/10.4103/0022-3859.198153. PMID: 28079043;
PMCID: PMC5394815.
4. Lincourt AE, Harrell A, Cristiano J, Sechrist C, Kercher K, Heniford BT. Retained foreign bodies after surgery. J Surg Res. 2007 Apr;138(2):170-4. https:// doi.org/10.1016/j.jss.2006.08.001. Epub 2007 Feb 1. PMID: 17275034.
5. Patial T, Thakur V, Vijhay Ganesun N, Sharma M. Gossypibomas in India - A systematic literature review. J Postgrad Med. 2017 Jan-Mar;63(1):36-41. https://doi.org/10.4103/0022-3859.198153. PMID: 28079043;
PMCID: PMC5394815.
6. Pole G, Thomas B. A Pictorial Review of the Many Faces of Gossypiboma - Observations in 6 Cases.Pol J Radiol. 2017 Aug 1;82:418-421. https://doi. org/10.12659/PJR.900745. PMID: 28819464; PMCID: PMC5549714.
7. Ryan G, Kawka M, Gnananandan J, Yip V. Presentation and surgical management of a gossypiboma presenting with small bowel obstruction. Clin J Gastroenterol. 2021 Aug;14(4):1067-1070. doi: 10.1007/s12328- 021-01400-y. Epub 2021 Mar 31. PMID: 33788165; PMCID: PMC8298332.
Files
IssueVol 6 No 1 (2023) QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/ajs.v6i1.14714
Keywords
Medico-legal Surgical Complication Foreign Body

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
H G V, N N, M P R. Unveiling the Hidden Peril: A Rare Case of Gossypiboma in an Elderly Woman. AJS. 2023;6(1):24-28.