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

ABSTRACT

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.