Gossypiboma (retained surgical sponge) induces septic shock after previous breast surgery: A case report

Foreign body granuloma caused by retained surgical sponge is also called gossypiboma or textiloma, is mostly described in the abdominal cavity, with only a very few cases of retained surgical sponges located in breasts. A 48-year-old female came to our emergency department due to shortness of breath with consciousness disturbance. Sixteen years previously, she had gone through modified radical mastectomy. Eight years later, she received breast reconstruction. At emergency department, her hemodynamic status was unstable. Besides, there was one mass lesion with abscess in the right axillary region, and percutaneous abscess drainage was performed. She was sent to the medical intensive care unit for further care of septic shock. Because her symptoms and signs did not improve, we decided to perform fasciectomy and surprisingly found one retained surgical sponge in her breast. After the operation, she recovered well and the wound was stable. Due to limited literature available, we present a case of gossypiboma in the breast with a clinical manifestation of septic shock.

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RETAINED SURGICAL SPONGE IN ABDOMEN – A CASE REPORT

10.36106/ijsr/8001678 ◽

2021 ◽

pp. 1-2

Author(s):

Navdeep Kaur ◽

Harvinder Singh Chhabra ◽

Amandeep Kaur

Keyword(s):

Case Report ◽

Foreign Body ◽

Early Diagnosis ◽

Abdominal Cavity ◽

Major Complication ◽

Surgical Sponge ◽

Retained Surgical Sponge ◽

Retained Foreign Body ◽

Undesirable Event ◽

Before And After

Retained foreign body is a major complication that can occur in early or delayed postoperative period having both clinical as well as medicolegal implications. We hereby report a case of 47-year-old female with retained surgical sponge in abdominal cavity after hysterectomy. Thorough count of all sponges before and after any surgery can aid in avoiding such an undesirable event and preferable use of labelled sponges can help in early diagnosis in such cases.

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Incidental Gossypiboma Discovered during Tricuspid Valve Re-Repair 11 Years after Ebstein Anomaly Repair

The Heart Surgery Forum ◽

10.1532/hsf98.20131015 ◽

2013 ◽

Vol 16 (4) ◽

pp. 216 ◽

Cited By ~ 1

Author(s):

Tornike Sologashvili ◽

Afksendiyos Kalangos ◽

C�cile Tissot ◽

Patrick O. Myers

Keyword(s):

Cardiac Surgery ◽

Tricuspid Valve ◽

Superior Vena ◽

Vena Cava ◽

Granulomatous Reaction ◽

Ebstein Anomaly ◽

Surgical Sponge ◽

Severe Tricuspid Regurgitation ◽

Retained Surgical Sponge ◽

The Right

Background: A retained surgical sponge, an extremely rare occurrence after cardiac surgery, can trigger a granulomatous reaction and form a sizeable mass or gossypiboma. We report the incidental operative finding of a gossypiboma 11 years after repair of Ebstein anomaly.Case Report: A 24-year-old man, who had previously undergone tricuspid annuloplasty for Ebstein anomaly 11 years earlier at another institution, was referred for recurrent severe tricuspid regurgitation. During the dissection along the superior vena cava and the right atrium, we entered 2 cystic cavities that exuded a pus-like material, which was sent for culture. Mesh from a retained surgical sponge (gossypiboma) was identified. After complete debridement and administration of vancomycin, the tricuspid valve was repaired. Antibiotics were continued until culture results were confirmed to be negative. The patient's postoperative course was uneventful, and he presented no signs of infection.Conclusions: We report a rare case of incidentally found gossypiboma after cardiac surgery.

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Pielonefrite Enfisematosa Fulminante Secundária a Neoplasia Urotelial com Fístula Renocólica

Acta Médica Portuguesa ◽

10.20344/amp.8869 ◽

2018 ◽

Vol 31 (2) ◽

pp. 129 ◽

Cited By ~ 1

Author(s):

Ana Rita Elvas ◽

Bruno Jorge Pereira ◽

Filipa Carrega ◽

Leopoldina Vicente

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Septic Shock ◽

Sphingomonas Paucimobilis ◽

Medical Team ◽

Test Results ◽

Emphysematous Pyelonephritis ◽

Post Operative Period ◽

Laboratory Test Results ◽

The Right

The emphysematous pyelonephritis is a uncommon and potentially fatal entity. The recognition of this condition enables the early correct management of patients. Diabetes and ureteral obstruction are the main risk factors identified. We present the case of a patient with no relevant risk factors or prior medical history, in which the reason of admission to the emergency department was back pain, eventually evolving into septic shock in the early hours. The imaging tests identified the presence of peri-renal and subcutaneous gas which guided the medical team to the right diagnosis (emphysematous pyelonephritis secondary to fistulized urothelial neoplasia) and the optimal surgical treatment. However, in the post-operative period the patient died, as the clinical condition and laboratory test results performed during the admission were predicting. It should also be mentioned that this same case illustrated a bacteraemia by Sphingomonas Paucimobilis (acquired in the community) with cavitated damage to lungs (probable septic embolism).

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Supra-aural gossypiboma: case report of a retained textile surgical sponge in an unusual location

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2016.0234 ◽

2016 ◽

Vol 98 (8) ◽

pp. e186-e188

Author(s):

N Chawla ◽

N Gupta ◽

N Dhawan

Keyword(s):

Surgical Complication ◽

Neck Region ◽

Surgical Excision ◽

Radical Mastoidectomy ◽

Ear Surgery ◽

Surgical Sponge ◽

Head And Neck Region ◽

Retained Surgical Sponge ◽

Modified Radical Mastoidectomy ◽

The Right

Gossypiboma or retained surgical sponge is an infrequently encountered surgical complication, more so in the head and neck region. A literature search did not reveal a previously reported case of retained or concealed surgical sponge after microscopic ear surgery. We present a unique and previously unreported case of a 25-year-old male who presented with a cystic swelling in the right supra-aural region 5 months post-modified radical mastoidectomy of the right ear. Surgical excision of the swelling revealed a retained surgical sponge. We emphasise the importance of counting surgical sponges after every surgical step to minimise the incidence of such retained surgical items.

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Gossypiboma after Breast Augmentation

Case Reports in Surgery ◽

10.1155/2013/808624 ◽

2013 ◽

Vol 2013 ◽

pp. 1-2

Author(s):

Kira Lundin ◽

Julie E. Allen ◽

Lene Birk-Soerensen

Keyword(s):

Plastic Surgery ◽

Breast Augmentation ◽

Breast Tissue ◽

Breast Implants ◽

Private Clinic ◽

Cosmetic Result ◽

Surgical Removal ◽

Surgical Sponge ◽

Retained Surgical Sponge ◽

The Right

A 39-year-old woman was referred for removal of cosmetic breast implants and related siliconoma. After an exchange of breast implants at a private clinic a year previously, she had asymmetry of the right breast, persistent pain, and a generally unacceptable cosmetic result. An MRI had shown a well-defined area with spots of silicone-like material at the upper pole of the right breast. Surgical removal of presumed silicone-imbibed breast tissue was undertaken, and surprisingly a gossypiboma was found in its place, which had not been identified on the MRI. Gossypiboma is the condition of an accidentally retained surgical sponge. This complication is also known as a textiloma, gauzoma, or muslinoma and is well described in other surgical specialties. However, it is extremely rare after plastic surgery, and this case illustrates the need for continued attention to the surgical count of sponges and instruments.

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Gossypiboma: An uncommon but avoidable dreadful complication

Urologia Journal ◽

10.1177/03915603211010636 ◽

2021 ◽

pp. 039156032110106

Author(s):

Amit Sharma ◽

Deepak Biswal ◽

Satyadeo Sharma ◽

Siddhant Roy

Keyword(s):

Abdominal Cavity ◽

Legal Issues ◽

Surgical Sponge ◽

Retained Surgical Sponge ◽

Clinical Presentations ◽

Avoidable Complication

Gossypiboma or retained surgical sponge in abdominal cavity is an avoidable complication which has wide variety of clinical presentations and associated medico-legal issues as well. The incidence is under-reported. Pre-operative diagnosis is difficult and management is surgical. We present a case of gossypiboma in a male with multiple vesico-cutaneous and colo-vesical fistulae.

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Gossypiboma versus Gossip-Boma

Case Reports in Radiology ◽

10.1155/2011/705062 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4

Author(s):

Charanjeet Singh ◽

Mamta Gupta

Keyword(s):

Pleural Cavity ◽

Surgical Intervention ◽

Rare Condition ◽

Surgical Sponge ◽

Retained Surgical Sponge ◽

Asd Closure ◽

The Right

Gossypiboma, or a retained surgical sponge, is a rare condition, and it can occur after any surgical intervention that requires use of internal swabs. A case of an eight-year-old girl is presented, who had right minithoracotomy for ASD closure. She was finally diagnosed to have a retained surgical sponge in the right pleural cavity.

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Surgical Sponge After Splenectomy: A Rare Case Report

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2551 ◽

2020 ◽

Vol 11 (3) ◽

pp. 3793-3795

Author(s):

Yashwant R. Lamture ◽

Varsha Gajbhiye ◽

Aditya Mundada

Keyword(s):

Foreign Body ◽

Operative Procedure ◽

Abdominal Cavity ◽

Postoperative Recovery ◽

Body Cavity ◽

Blunt Injury ◽

Lumbar Region ◽

Surgical Sponge ◽

Retained Foreign Body ◽

The Right

A gossypiboma is a cotton sponge retained in the abdominal cavity after the operative procedure. It leads to tremendous morbidity, loss of money and even occasional death of the patient. Another problem on the part of treating the surgeon is defamation and medicolegal issue. We report a case of a 25- year young man presented with pain in abdomen and vomiting for six months, History of a lump in the right lumbar region for two months and with constipation for five days. He had operated for splenectomy after a blunt injury to the abdomen eight months back. On clinical examination, adhesive obstruction of bowel was suspected. On computed tomography, (CT), a foreign body was revealed. On laparotomy, there was evidence of sponge in a jejunum. By doing enterotomy, a large sponge was removed. Postoperative recovery was not associated with significant complications. An essential precaution is to look for retained foreign body and confirmation before the closure of any body cavity, as there may even after all precautionary exercises, occur retention of foreign bodies. Hence consider always the possibility of gossypiboma in the differential diagnosis of chronic abdominal pain or a mass in patients with a history surgery.

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