Vesical Gossypiboma with Urethral Migration Causing Acute Urinary Retention: A Case Report and Review of the Literature

Introduction: Vesical gossypiboma is a retained surgical sponge in the urinary bladder following abdominal or pelvic surgery. It is probably under-reported due to medico-legal issues. It usually poses a diagnostic challenge to clinicians. A high index of suspicion is essential to make a timely diagnosis. Case Presentation: We present a case of vesical gossypiboma in a 64-year-old male patient who presented with a history of persistent lower urinary tract symptoms (LUTS) and acute urinary retention following trans-vesical prostatectomy. The urinary retention was relieved by a suprapubic cystostomy. On cystoscopic examination, a large whitish spongiform structure in the urethra and bladder was revealed. A gentle attempt of cystoscopic removal was failed. At exploration, a retained surgical sponge was revealed and removed from the bladder. Postoperatively, the patient reported improvement of symptoms and was passing urine normally. Discussion Vesical gossypiboma is relatively rare as very few isolated cases have been reported, and its migration through the urethra is even rarer. Patients with intravesical gossypiboma may manifest with either acute or chronic symptoms due to complications. Gossypiboma is an avoidable condition, and its occurrence can be prevented by thorough exploration of the surgical site and count of surgical materials at the end of the procedure. Conclusion Vesical gossypiboma should be considered as a differential diagnosis in patients with persistent LUTS following open bladder or prostate surgery. Open surgical removal is one of the feasible treatment options. But prevention is a preferable solution.

Vesical Gossypiboma with Urethral Migration Causing Acute Urinary Retention: A Case Report and Literature Review

Introduction: Vesical gossypiboma is a retained surgical sponge in the urinary bladder following abdominal or pelvic surgery. It is probably under-reported due to medico-legal issues. It usually poses a diagnostic challenge to clinicians. A high index of suspicion is essential to make a timely diagnosis. Case Presentation: We present a case of vesical gossypiboma in a 64-year-old male patient who presented with a history of persistent lower urinary tract symptoms (LUTS) and acute urinary retention following trans-vesical prostatectomy. The urinary retention was relieved by a suprapubic cystostomy. On cystoscopic examination, a large whitish spongiform structure in the urethra and bladder was revealed. A gentle attempt of cystoscopic removal was failed. At exploration, a retained surgical sponge was revealed and removed from the bladder. Postoperatively, the patient reported improvement of symptoms and was passing urine normally. Clinical Discussion: Vesical gossypiboma is relatively rare as very few isolated cases have been reported, and its migration through the urethra is even rarer. Patients with intravesical gossypiboma may manifest with either acute or chronic symptoms due to complications. Gossypiboma is an avoidable condition, and its occurrence can be prevented by thorough exploration of the surgical site and count of surgical materials at the end of the procedure. Conclusion Vesical gossypiboma should be considered as a differential diagnosis in patients with persistent LUTS following open bladder or prostate surgery. Open surgical removal is one of the feasible treatment options. But prevention is a preferable solution.

Retained surgical sponge presenting as a case of intestinal obstruction

Retained surgical sponge or gossypiboma is a term used to describe a retained swab in the body after operation. There are different surgical materials that can be left in the abdomen during operation such as sponge, artery forceps, scissors, and pieces of broken instrument. Mop is the most commonly retained foreign body. Inadvertent retention of foreign body in the abdomen often requires another operation, increasing the morbidity and mortality in these patients. Despite the complications associated with this condition, they are rarely published because of medicolegal implications. We report a case of 28-year-old woman who presented on account of 9 months history of colicky abdominal pain, abdominal distention and mass following open myomectomy in a private hospital.

Spectrum of CECT Findings of Retained And Migrated Surgical Items In Abdomen – A Series of Seven Cases.

Background: Various retained surgical items often present a diagnostic dilemma to the interpreting radiologist. These items include retained surgical sponge (gossypiboma), misplaced, migrated catheters, broken instruments, irrigation sets, and a variety of surgical paraphernalia. Such foreign bodies present with varying imaging findings and can often mimic other diseases radiologically.Case presentations: We present a series of seven interesting cases of retained surgical mops (case 1, 2 and 3), broken and retained surgical instrument (case 4), migrated plastic biliary stent (case 5), migrated contraceptive device (case 6) and surgically placed hemostatic agent (case 7)Conclusions: Familiarity with the variable imaging findings and communication with the clinician can facilitate timely management for these patients.

Gossypiboma: An uncommon but avoidable dreadful 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.

RETAINED SURGICAL SPONGE IN ABDOMEN – A CASE REPORT

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.

Gossypiboma with perforation of the umbilicus mimicking a complicated urachal cyst: a case report

Background A retained surgical sponge, also known as a gossypiboma, is a rare cause of serious postoperative complications. Diverse retained surgical materials including instruments such as clamps and sutures have been reported, but surgical sponges are the most common material. We report an unusual case of a gossypiboma mimicking a complicated urachal cyst that led to perforation of the umbilicus. Case presentation A 38-year-old female patient presented in our facility with a palpable periumbilical mass and discharge of pus from the umbilicus for 7 months after an open appendectomy. Since the onset of symptoms, the patient had been treated conservatively in a peripheral hospital where she had been operated on. As no improvement was seen, an ultrasound scan was performed that suggested an intraperitoneal abscess adjacent to the umbilicus. Consequently, the patient was referred to our specialist outpatient department for surgical intervention. Suspecting a complicated urachal cyst, an exploratory laparotomy was performed but revealed a retained surgical sponge as the underlying cause. The gossypiboma was resected, and the postoperative period was unremarkable. Conclusion This case demonstrates that gossypibomas, even though rare, continue to occur. They may clinically and radiologically mimic other pathologies, especially abscesses and tumors. Preventive measures as well as the inclusion of gossypibomas in the differential diagnosis of intraabdominal masses or fistulation detected in patients with a history of surgery are of utmost importance to minimize morbidity, mortality, and potential medicolegal implications.