Textiloma abdominal: actualización y aporte al diagnóstico desde las imágenes

Textiloma es un término utilizado para describir una masa formada por textiles quirúrgicos olvidados al interior de un paciente y la reacción a un cuerpo extraño que los rodea. Su incidencia ha disminuido considerablemente, sin embargo, su alto impacto legal y social ha motivado su revisión. Se realizó una búsqueda de artículos relacionados con textilomas vía Pubmed y SCielo, incluyendo un total de 25 referencias. La presentación clínica es variada e inespecífica; la ubicación, tiempo de evolución y tipo de respuesta inflamatoria inciden en un amplio espectro de escenarios clínicos, desde un hallazgo incidental en imágenes hasta un cuadro grave secundario a complicaciones (abscesos, obstrucción intestinal, sepsis, entre otros). En este contexto se hace fundamental el apoyo imagenológico. La radiografía simple suele ser el acercamiento inicial por su fácil acceso e interpretación, pero el marcador radiopaco puede desintegrarse o distorsionarse con el tiempo. La tomografía computada permite una mayor sensibilidad para el diagnóstico, pero puede ser fácilmente malinterpretada como una neoplasia, absceso o hematoma si no se conocen las características distintivas. La presencia de una masa de contenido espongiforme hipodenso con burbujas en su interior y una pared que realza con contraste o la de una masa reticular rodeada de una corteza calcificada deben orientar a su diagnóstico. Los textilomas son en definitiva problemas complejos, no sólo desde el ámbito legal y social sino también desde un punto de vista médico, siendo el estudio de imágenes y el antecedente de un procedimiento quirúrgico las claves para un diagnóstico oportuno.

Gossypiboma is a term used to describe a mass formed by textiles left inside a patient during surgery and the foreign body reaction that surrounds it. Its incidence has considerably decreased over time; however, its legal and social impact has motivated its revision. Articles were searched via PubMed and SCielo and a total of 25 references were included from it. Gossypibomas have a wide and nonspecific clinical presentation; location, time of evolution, and type of inflammatory response determine the wide spectrum of clinical scenarios that can go from an incidental diagnosis in images to severe clinical condition secondary to complications (abscess, bowel obstruction, sepsis, within others). In this context, imaging support becomes essential. Plain radiography is usually used as the initial approach due to its easy access and interpretation; however, the radiopaque marker can distort or disintegrate over time. The computed abdomen tomography allows an increased sensitivity for the diagnosis but findings can easily be misinterpreted as a neoplastic disease, abscess or hematoma if the distinctive characteristics are not known. The finding of a hypodense spongiform mass with air bubbles inside and contrast enhanced wall or a reticular mass surrounded by a calcified cortex should guide us to its diagnosis. Gossypiboma is definitely a complex issue, not only from a legal and social scope but also from a medical point of view, being the study by images and the history of surgical procedures the keys for a timely diagnosis.

Arritmia ventricular maligna asociada a un gossypiboma: reporte de un caso / Malignant ventricular arrhythmia associated to gossypiboma: clinical case report / Arritmia ventricular maligna vinculada a gossypiboma: reporte de um caso clínico

Un gossypiboma, oblitoma o textiloma se define como todo cuerpo extraño olvidado en el interior de un paciente durante una intervención quirúrgica. Representa una complicación posquirúrgica poco frecuente pero de consecuencias potencialmente graves. En general, se manifiesta con cuadros clínicos variables: una masa o pseudotumor, sangrados, fiebre, dolor, varios meses o años después de la cirugía original. También puede ser un hallazgo accidental. Describimos el caso clínico de una paciente con un gossypiboma vinculado a una cirugía cardíaca que se realizó 40 años antes al cuadro clínico actual, que se presenta con arritmia ventricular maligna.

A gossypiboma, oblitoma or textiloma is defined as a surgical object left in the interior of the body after surgery. It represents an uncommon but potentially life threatening post-surgery complication. Clinical manifestations are variable and depend on location, relations and size, from pseudo-tumoral masses, bleeding, fever, pain and other nonspecific presentations. The onset of symptoms is unpredictable, occurring from months or years after surgery. Patients may course asymptomatically and be diagnosed incidentally as an imaging finding. We describe a case of a patient with gossypiboma diagnosed 40 years after undergoing cardiac surgery, who presented with a malignant ventricular arrhythmia.

Um gossypiboma, oblitoma ou textiloma está definido como todo corpo estranho esquecido no interior de um paciente durante um procedimento cirúrgico, representando uma complicação pos cirúrgica pouco frequente, mas com consequências potencialmente graves. Geralmente, se manifesta com quadros clínicos variáveis: uma massa ou pseudotumor, sangramentos, febre, dor, varios meses ou anos após a cirurgia original ou ser um hachado acidental. Descrevemos o caso clínico de uma paciente com um gossypiboma vinculado a uma cirurgia cardíaca realizada 40 anos antes do quadro clínico atual, que se apresenta com arritmia ventricular maligna.

Transmurally migrated gossypiboma rarely posing as surgical site infection: a case report and review of literature

The term gossypiboma is used to describe a retained surgical sponge or gauge after surgery. The clinical features range from being asymptomatic to frank bowel obstruction, perforation and peritonitis. Radiological modalities also do not provide a definite diagnosis. We report a case of a 30-year-old lady who presented to the emergency room with recurrent surgical site infection. She had a history of caesarean section 5 months ago. Following the caesarean section, she developed superficial wound dehiscence which was re-sutured. At the present facility, the lady underwent Computed tomography (CT) scan and was suspected to have a foreign body around the gut. She was planned for an exploratory laparotomy. Upon laparotomy, a large thick-walled ileal loop with some unusual intra luminal mass was found. Dense adhesions were present between the ileal loop and sigmoid colon. Adhesiolysis led to an iatrogenic sigmoid colon perforation, around 2 cm length. On incision over the ileal loop, surgical sponge was retrieved. Ileal loop was resected along with perforated site with end-to-end ileo-ileal anastomosis was done. Primary repair of sigmoid colon perforation was done. Patient was stable in postoperative period. Although rare, gossypiboma should be kept in mind as a differential diagnosis in postoperative cases presenting with recurrent surgical site infection.

Gossypiboma: a surgical menace

Gossypiboma is a rare yet devastating complication. It may be a sequela to any kind of surgical procedure, however intra-abdominal surgeries are commonly implicated as the cause for this entity. In chronic cases, it may even lead to severe morbidity. We report a case of gossypiboma post vaginal hysterectomy, diagnosed and treated successfully by laparoscopy.

Nephrocutaneous fistula due to textiloma with in the pelvicalyceal system

Textiloma or gossypiboma is an embarrassing surgical scenario. Nephrocutaneous fistula is itself a rare complication after renal surgeries, but due to textiloma, it is rarest of the rare. In this case, 30-year-old lady presented with the complaints of chronic seropurulent discharge from a wound on her right lumbar region. On exploration it was found to be a retained surgical sponge in pelvicalyceal system, which was there for last seven years.

Mistakes of Surgeons: “Gossypiboma” Sometimes Brings Grave Consequence to the Patient

Retained surgical mop in the abdominal cavity is a serious butavoidable complication which may manifest either as aninflammatory reaction with formation of abscess and fistula orwith a fibrotic reaction developing into a mass. We report thecase of a 25 years old women who presented four monthsafter a Caesarean section with features of intestinalobstruction. Plain abdominal radiograph and ultrasound scanraised high index of suspicion of the presence of gossypibomaand the diagnosis was confirmed at laparotomy. Even after 2ndand 3rd look surgery, the patient faced a sad demise.Gossypiboma, term derived from the latin ‘gossypium’ (cotton)and the swahilli ‘boma’ (place of concealment) is the term formretained surgical sponge. Two usual responses to retainedmops are exudative inflammatory reaction to develop a mass.Intraluminal migration is rare, leading to obstruction. Patientmay develop symptoms of abdominal pain, nausea, vomitingand weight loss resulting from obstruction or a malabsorptionsyndrome caused by multiple intestinal fistulas or intraluminalbacterial overgrowth. Early recognition of this entity will ensureprompt diagnosis and appropriate treatment, reducingmorbidity and mortality in such patients.

Gossypiboma vesical: reporte de 2 casos y revisión de la literatura / Bladder gossypiboma: report of 2 cases and review of the literature

La presencia de gasas intracavitarias posterior a procedimientos quirúrgicos es una situación que genera importantes complicaciones, con graves repercusiones médico-legales. El objetivo de este estudio es describir la presencia de un cuerpo extraño vesical como complicación iatrogénica. Se presentan dos casos, el primero es de un hombre de 63 años de edad, con antecedente de prostatectomía simple por hiperplasia prostática benigna, quien acude por episodio de retención aguda de orina (RAO); y el segundo es de una mujer de 65 años, con antecedente de histerectomía abdominal por leiomiomatosis uterina, quien presenta dolor pélvico crónico e infecciones urinarias a repetición. A los pacientes se les realizó un ecosonograma pélvico que reportó lesión ocupante de espacio en vejiga, la urotomografia (urotac) evidencia un cuerpo extraño intravesical de apariencia radiopaca, y en la uretrocistoscopia se visualiza material sintético intravesical flotando. Al primer paciente se le realiza una cistotomía con extracción de material compatible con gasa y a la segunda paciente se le realiza extracción endoscópica de la misma, ambos presentando evolución satisfactoria. La revisión del sitio quirúrgico y el contaje transoperatorio de gasas antes de la síntesis final de los tejidos es un paso fundamental para el éxito de una cirugía pélvica(AU)

The presence of intracavitary gauzes after the surgical procedures is a situation that generates important complications, with serious medico-legal repercussions. The objective of this study is describe the presence of a bladder foreign body as an iatrogenic complication. Two cases are presented, the first is from a 63-year-old man with a history of simple prostatectomy for benign prostatic hyperplasia who presents with episodes of acute urinary retention; and the second is a 65-year-old woman with a history of abdominal hysterectomy due to leiomyomatosis that presents with chronic pelvic pain and recurrent urinary tract infections. A pelvic ecosonogram was performed on the patients who reported a bladder space-occupying lesion, urotac showed an intravesical foreign body with a radiopaque appearance, and intravesical synthetic flotation material was visualized in the urethrocystoscopy. The patient underwent a cystotomy with gas-compatible material extraction and the patient underwent endoscopic extraction, both showing a satisfactory evolution. Surgical site revision and transoperative gauze infection before the final synthesis of tissues is a fundamental step for the success of pelvic surgery(AU)

Oblitos en Cirugía: análisis de casuística y estrategias para su prevención / Foreign body: case analysis and prevention strategies / Oblitos em Cirurgia: análise de caso e estratégias de prevenção

Introducción: El oblito es un evento de muy baja frecuencia pero que puede generar morbilidad grave. Si bien se han reconocido algunos factores de riesgo y desarrollado sistemas complementarios de detección, continua siendo un gran problema desde el punto de vista sanitario y médico legal. Objetivos: Analizar una casuística del Hospital Maciel, su forma de presentación y complicaciones. Pacientes y métodos: Se presentan 7 pacientes asistidos en los Servicios de Cirugía General y Urología del Hospital Maciel, en el período comprendido del 2013 - 2016. Las principales variables que se analizan son la forma de presentación y complicaciones, así como presencia de factores de riesgo. Resultados: El hallazgo fue de compresas en todos los pacientes. En 2 casos el oblito fue asintomático y en otros 4 sintomático. En los últimos, 2 tuvieron una presentación temprana y 2 tardía. El recuento de material fue incorrecto solamente en un caso. Ningún paciente falleció por las complicaciones resultantes. Discusión: El oblito en cirugía es un problema que seguirá existiendo en tanto existan los procedimientos quirúrgicos, por lo que es necesario hacer énfasis en el abordaje sistemático, existiendo también métodos auxiliares de diagnóstico que podrían comenzar a implementarse. Conclusiones: Encontramos casi sin excepción la presencia de factores de riesgo conocidos en nuestra serie, si bien el número de casos es reducido. También la incidencia impresiona ser algo más elevada de la señalada en la literatura.

Introduction: Retained foreign items are infrequent but can generate serious morbidity. Although some risk factors have been recognized and complementary detection systems developed, it continues to be a major problem from a health and medical legal point of view. Objectives: to examine a case study at Hospital Maciel, focusing on clinical presentation and complications. Patients and methods: 7 patients treated at the General Surgery and Urology Departments in Hospital Maciel, between 2013-2016. The main results analized are clinical presentation and complications, as well as the presence of recongnized risk factors. Results: In all patients, the foreign bodies were compresses. In 2 cases the foreign body did not elicit symptoms whereas in 4 cases it did. In the latter, 2 had an early and a late presentation. The material count was incorrect in only one case. No patient died from the resulting complications Discussion: Because retained surgical ítems will be a problem as long as surgical procedures are performed, it is necessary to emphasize on a systematic approach accompanied by complementary diagnostic tools that are also available in cases of item miscount. Conclusions: Risk factors were present almost without exception in our casuistry. Also, the incidence seems to be higher than that reported in the literature.

Introdução: Oblito é um evento de baixa freqüência, mas que pode gerar uma grave morbidade. Embora alguns fatores de risco tenham sido reconhecidos e desenvolvidos sistemas de detecção complementares, continua a ser um grande problema do ponto de vista da saúde e do direito médico legal. Objetivos: Analisar uma casuística do Hospital Maciel, sua apresentação e complicações. Pacientes e métodos: sete pacientes foram atendidos nos Serviços de Cirurgia Geral e Urologia do Hospital Maciel, no período entre 2013 e 2016. As principais variáveis analisadas são a apresentação e complicações, bem como a presença de fatores risco. Resultados: a descoberta foi de compressas em todos os pacientes. Em 2 casos, o oblito foi assintomático e em 4 casos foi sintomático. No segundo, em 2 a apresentação foi temprana e em 2 foi tardia. A contagem de materiais estava incorreta em apenas um caso. Nenhum paciente morreu pelas complicações resultantes. Discussão: o oblito em cirurgia é um problema que continuará a existir enquanto houver procedimentos cirúrgicos, por isso é necessário enfatizar a abordagem sistemática, e também há métodos de diagnóstico que podem ser implementados. Conclusões: encontramos quase sem exceção a presença de fatores de risco conhecidos em nossa série, embora o número de casos seja pequeno. A incidência também parece ser um pouco maior do que a relatada na literatura.

A 20-Year-Old Retained Surgical Gauze Mimicking a Spinal Tumor: A Case Report

A 79-year-old man visited our clinic complaining of lower back and left leg radiating pain that began 1 month prior to his presentation. He underwent surgery for lumbar disc herniation 20 years ago at another hospital. Magnetic resonance imaging revealed left-sided foraminal stenosis at L4-5. In addition, a paraspinal mass occupying the L4 spinous process and left lamina was observed. We subsequently performed an L4-5 decompression and fusion. During the operation, retained surgical gauze with granulation tissue was found. The term gossypiboma is used to define a mass lesion consisting of retained surgical gauzes and an adjacent foreign body reaction. Gossypibomas are uncommon in the paraspinal area and are mostly asymptomatic in chronic cases. Because there are no specific clinical or radiological signs, they can be confused with other tumorous conditions. Gossypibomas should be included in the differential diagnosis of paraspinal soft-tissue masses detected in patients with a history of prior spinal surgery.

Nonspecific Computed Tomography Presentation of Gossypiboma.

A gossypiboma also known as ‘textiloma’ or ‘cottonoid’ is a term used to describe a foreign object (nonabsorbable surgical material), that is left behind in a body cavity during an operation. The manifestations and complications of gossypiboma are so variable that diagnosis may be difficult and patient morbidity is thus significant. Moreover, such foreign bodies can often mimic tumors or abscesses. Here we discuss a case of pelvic gossypiboma that presented as a mass in the pelvis associated with abdominal pain in a post ovarian cystectomy case. The diagnosis was suggested on computed tomography (CT). The diagnosis was confirmed on surgery and the gossypiboma was retrieved successfully.

Gossypiboma: To Err is Human – A Case Report

Gossypiboma (retained surgical sponge) is one of the identities that can be a disaster not only to the carrier of operating surgeon but also for the hospital as far as the financial burden and the reputation is concerned. The patient may have severe morbidity and in worst of the event can have mortality. The aim of this article is to highlight the fact that the incidence is not as rare as has been reported in different literatures and to discuss its various –clinico-radiological features, predisposing factors, measures to avoid it and how to manage when such a calamity has occurred. This article increases the awareness about the problem thus avoiding unnecessary morbidity/mortality to the patient as well as save the surgeon from malpractice law suits, great psychological trauma and negative publicity.

Duodenal gossypiboma: a case report and literature review / Gossypiboma duodenal: reporte de un caso y revisión de la literatura

Gossypiboma is a retained surgical cotton matrix material in the body after a surgical procedure. Cases are rarely reported due to medico-legal concerns. Although infrequent, it causes serious morbidity and even mortality if left undiagnosed. We present the case of a trans-mural migration of gossypiboma and a review of the literature. Gossypiboma’s trans-duodenal migration is a rare complication of retained gauzes. Cases reported in the literature were easy to diagnose based on clinical grounds and endoscopic studies.

La palabra gossypiboma define una gasa o matriz de algodón retenida en el organismo después de un procedimiento quirúrgico. Se reportan con poca frecuencia debido a las implicaciones médico-legales. A pesar de ser poco frecuentes, pueden ser causa de morbilidad si no se diagnostican. En el presente trabajo se reporta un caso de un gossypiboma con migración transduodenal. La migración transduodenal de un gossypiboma es una complicación rara que suele diagnosticarse sin dificultad con base a la clínica y a la endoscopía.

Undiagnosed Chronic Abdominal Pain and Colonic Perforation: A Rare Cause: Gossypiboma.

The term gossypiboma is used to describe as a mass due to retained surgical sponge after surgery. It is rare, but serious complication that is seldom reported because of the legal implications. The present study was carried out at the tertiary health center from January 2013 to April 2015. Five cases were studied prospectively. Gossypiboma usually has a varied and a vague presentation that makes it difficult to detect on radiological investigations. Sometimes, it can remain quiescent and could even present years after the operation. Though rare, gossypiboma should be kept in mind as a differential diagnosis in post-operative cases presenting as vague pain or recurrent chronic abdominal pain or long term foul smelling sinus discharge even years after the operation. Four out of five cases had colonic perforation, which was managed by primary closure. Fecal diversion was not required in any of the patient. Gossypiboma is avoidable, but serious rare post-operative complication. It is usually asymptomatic and has non-specific radiological findings. Hence, the diagnosis is often delayed. Gossypiboma can cause wide variety of complications like perforation and adhesion to the adjacent structures.

Laparoscopic Removal of Gossypiboma Following Cesarean Section

Gossypiboma refers to a tumorus mass that is caused by a foreign body reaction due to an accidentally retained gauze or sponge within the body following surgery. Here, we report the case of gossypiboma in a 29-year-old woman with lower abdominal discomfort over a period of 2 years. In her medical history, she had a Cesarean section 11 years ago. Transvaginal ultrasonography showed an 8.5x6.4 cm mixed echoic round mass and both adnexa were normal. Abdominal-pelvic computed tomography confirmed a high attenuation lesion with a suspected foreign body in the pelvic cavity. Thus, based on a diagnosis of gossypiboma, she received a laparoscopic operation. Upon laparoscopic view, the mass was discovered to be well encapsulated and solid, and located between the urinary bladder and uterus. The mass was completely removed without damage to other adjacent organs. The patient was discharged on the 5th postoperative day without complications.

A Case of Gossypiboma Associated with Xanthogranulomatous Inflammation / 대한이비인후과학회지

A mass formed around a cotton matrix left within the body is termed as gossypiboma. It is a rare complication of surgery and often occurs mainly after abdominal operations. The incidence of gossypiboma is underreported, due to legal implications of their detection. Furthermore, a correct diagnosis can be made only in one-third of cases. Clinical presentation is variable, depending on the location of the foreign body and on the type of inflammatory reaction. The recommended choice of treatment is excision, with the most important consideration given to prevention. Xanthogranulomatous inflammation is an uncommon form of chronic inflammation, which is destructive to affected organs. To the best of our knowledge, we report the first case of gossypiboma associated with xanthogranulomatous inflammation. A gauze accidently left in the lateral neck after a neuro-surgical intervention was found during resection of mass-like lesion and xanthogranulomatous inflammation was diagnosed on histopathologic exam.

Gossipiboma após operação abdominal é situação clínica desafiadora e sério problema médico legal / Gossypiboma after abdominal surgery is a challenging clinical problem and a serious medicolegal issue

INTRODUÇÃO: O termo gossipiboma refere-se à matriz que contém material têxtil e à reação tecidual formada ao redor deste corpo estranho. As gazes e as compressas cirúrgicas são os materiais mais frequentemente retidos após laparotomias. OBJETIVO: Estudar a incidência e as causas de gossipiboma abdominal, além das medidas preventivas para reduzir a sua frequência e morbimortalidade. MÉTODO: Foi realizada revisão da literatura na língua inglesa no Medline / Pubmed. A pesquisa envolveu os últimos 10 anos, selecionando os seguintes descritores - gossipiboma, textiloma, corpo estranho retido e cirurgia abdominal.Trinta artigos foram considerados para a revisão. RESULTADOS: A incidência é subestimada, principalmente pelas implicações legais decorrentes de tal achado, mas também porque muitos pacientes permanecem assintomáticos. Ocorrem em 1/1000 a 1/1500 operações abdominais. A apresentação clínica é variável e depende da localização do corpo estranho e do tipo de reação inflamatória apresentado pelo hospedeiro. A migração transmural é rara. O tratamento recomendado é a excisão, realizado por via endoscópica, laparoscópica ou por laparotomia, com o objetivo de evitar as complicações que podem atingir alta mortalidade. A abordagem mais importante é a prevenção. As medidas preventivas incluem o uso de material têxtil com marcadores radiopacos, exploração detalhada da cavidade abdominal ao final do procedimento operatório e contagem meticulosa do material cirúrgico. CONCLUSÃO: Gossipiboma é problema médico-legal antigo, cuja incidência aparentemente está aumentando e que precisa ser reabordado para que medidas preventivas efetivas sejam adotadas na sala de operação.

INTRODUCTION: The term "gossypiboma" refers to a textile matrix surrounded by foreign body reaction. Gauze and surgical dressings are the most commonly retained materials after laparotomy. AIM: To evaluate the incidence of abdominal gossypiboma, its causes and the preventive measures to reduce the frequence and morbimortality. METHOD: Was conducted a literature review in Medline/Pubmed in english. The survey was about the last 10 years, selecting the headings: gossypiboma, textiloma, retained foreign body and abdominal surgery. Thirty articles were considered in this review. RESULTS: The incidence of gossypiboma is underreported, mostly due to the legal implications of their detection but also because many patients remain asymptomatic. Occur in 1/1000 to 1/1500 of intra-abdominal operations. Clinical presentation is variable, and depends on the location of the foreign body and on the type of inflammatory reaction presented by the host. The recommended course of treatment is excision, which can be accomplished endoscopically, laparoscopically, or via the open route, and seeks to prevent the complications that lead to a high mortality rate. The most important approach is prevention. Preventive measures required include exploration of the abdominal cavity at the end of the procedure, use of textiles with radiopaque markers and a meticulous account of surgical materials. CONCLUSION: Gossypiboma is a former medical-legal problem, whose incidence is apparently increasing. Therefore needs to be revised to take preventive measures in the operating room.

Gossypiboma of the Neck Mimicking an Isolated Neck Recurrence

A gossypiboma (also called textiloma or retained surgical sponge) of the neck is rarely reported compared to intraabdominal or intrathoracic gossypibomas and also can be misdiagnosed as metastatic lymph nodes. A patient was referred to our clinic for a supraclavicular neck mass 6 months after thyroidectomy and neck dissection for papillary thyroid carcinoma in another hospital. It was initially considered an isolated neck recurrence, but it was finally diagnosed as gossypiboma by a pathological examination of the surgically-excised specimen. Characteristic findings of computed tomography or positron emission tomography/computed tomography might be helpful to differentiate the gossypiboma from malignant neck mass or other inflammatory conditions. It is essential for clinicians to be aware of this disease entity in differential diagnosis of neck recurrence because a gossypiboma in the neck can be misinterpreted as a malignancy to induce unwarranted radical surgery.

Gossypiboma: el sempiterno problema de los cuerpos extraños retenidos y el privilegio del internista / Gossypiboma: the always present problem of surgical strange object`s retention and the internis` privilege

La retención de objetos quirúrigicos o cuerpos extraños durante un acirugía, es un problema ampliamente reconocido en el sistema de atención de la salud. Causa daño a los pacientes, proveedores, hospitales, comunidades y al sistema de atención dela salud como todo. También resulta en gastos inncesarios. La retención de objetos quirúrgicos es un problema totalmente evitable. Se presenta el caso de una mujer diabética que presentó una parálisis incompleta tercer nervio central y durante la explotación física integral, privilegio del internista, se encontró un tumor abdominal asintomátco. La tomografía computarizada fue compatible con una retención de objetos quirurgicos. Este artículo exmina los factores de riesgo para que ocurra la retención, examina los métodos actuales de prevención y los estudios de las nuevas tecnologías que se han desarrollado para evitar este error médico

The retention of surgical objects is a widely recognized problem within the health care system. It causes harm to patients, providers, hospitals, communities, and to the health care system as a whole. It also results in needless expense. The retention of surgical objects is a problem completely preventable. We presented the case of a diabetic woman who presented with incomplete third nerve palsy and incidentally, as an internist`s privilege, an asymptomatic abdominal tumor was clinicaly found. The computarized tomography scan was compatible with a retention of surgical objects. This article reviews the risk factors for retention of surgical objects, examines the current methods of prevention, and surveys the new technologies that have been developed to prevent this medical error

Avaliação por imagem dos gossipibomas abdominais / Imaging findings of abdominal gossypibomas

O termo gossipiboma é usado para descrever uma massa formada a partir de uma matriz de algodão cercada por uma reação inflamatória/granulomatosa. Sua incidência é estimada em 0,15 por cento a 0,2 por cento. O corpo estranho na cavidade abdominal pode servir de nicho para a proliferação de microrganismos e agir como foco primário para formação de abscessos e de peritonite. Vários estudos têm demonstrado a importância da correlação clínica com os diversos métodos de imagem (radiografia convencional, ultrassonografia, tomografia computadorizada e ressonância magnética) no diagnóstico dos gossipibomas. Este ensaio tem por objetivo demonstrar uma série de casos típicos de gossipibomas abdominais e ilustrar suas diversas formas de apresentação, com ênfase nos achados dos diferentes métodos de imagem, visando a familiarizar os radiologistas com esta enfermidade e seus principais diagnósticos diferenciais.

Gossypiboma is a term utilized to describe a mass developed from a matrix of cotton fibers surrounded by inflammatory granulomatous reaction. Its incidence is estimated at 0.15 percent to 0.2 percent of laparotomies. A foreign body within the abdominal cavity may provide a niche for proliferation of microorganisms, acting as primary focus for development of an abscess and peritonitis. Several studies have demonstrated the relevance of clinical correlation with the findings of different imaging methods (conventional radiography, ultrasonography, computed tomography and magnetic resonance imaging) in the diagnosis of gossypibomas. The present pictorial essay is aimed at demonstrating a series of typical cases of abdominal gossypibomas and illustrating the several presentations of such mass, with emphasis on the findings at different imaging methods in order to familiarize radiologists with this entity and with the main differential diagnosis.