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

ABSTRACT

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.