Gossypiboma mimicking a distal pancreatic mass: Report of a case

• Authors: Savas Yakan , Safak Oztürk , Mustafa Harman , Oktay Tekesin , Ahmet Coker
• Languages of publication: EN

Abstracts

EN

Gossypiboma (retained surgical sponge) is a pseudotumor within the body that is composed of non-absorbable surgical material with a cotton matrix. Because the symptoms of gossypiboma usually are nonspecific and may appear years after surgery, the diagnosis of gossypiboma may be difficult because the condition may mimic a benign or malignant soft-tissue tumour in the abdomen and pelvis. A 61-year-old woman with a one-year history of left upper-quadrant pain and weight loss was referred to our center. She had undergone peptic ulcer perforation 23 year ago. Physical examination revealed dullness and palpable mass in the left upper abdomen. On examination by computed tomography (CT), a hypodense mass of 12 cm in diameter between the greater curvature of the stomach, pancreas, and splenic hilus was detected. Upon exploration, a mass lesion of 10 cm in diameter was detected between the greater curvature of the stomach and splenic hilus, which caused dense adhesions not in communication with the pancreas. It was excised and a splenectomy was performed. After a macroscopic examination, the mass lesion was diagnosed as gossypiboma. Although ultrasonography (US), CT, angiography, and magnetic resonance imaging (MRI) may be used to diagnose gossypiboma, definitive diagnosis is possibile only upon surgery or histopathological examination. As a result, when an abdominal mass is observed, surgeons should carefully investigate the patient’s past surgical history while taking the possibility of gossypiboma into consideration.

Keywords

EN

Gossypiboma; Pancreas; Intra-abdominal mass

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2010
• Volume: 5
• Issue: 1
• Pages: 136-139

Dates

published

1 - 2 - 2010

online

29 - 1 - 2010

Contributors

author

Savas Yakan

• Department of Surgery, Hepatopancreatobiliary Division, Ege University Faculty of Medicine, 35270, Izmir, Turkey

author

Safak Oztürk

• Department of Surgery, Hepatopancreatobiliary Division, Ege University Faculty of Medicine, 35270, Izmir, Turkey

author

Mustafa Harman

• Department of Radiology, Ege University Faculty of Medicine, 35270, Izmir, Turkey

author

Oktay Tekesin

• Department of Gastroenterology, Ege University Faculty of Medicine, 35270, Izmir, Turkey

author

Ahmet Coker

• Department of Surgery, Hepatopancreatobiliary Division, Ege University Faculty of Medicine, 35270, Izmir, Turkey

References

• [1] Yildirim S, Tarim A, Nursal TZ, Yildirim T, Caliskan K, Torer N et al., Retained surgical sponge (gossypiboma) after intraabdominal or retroperitoneal surgery: 14 cases treated at a single center., Langenbecks Arch Surg, 2006, 391, 390–395 http://dx.doi.org/10.1007/s00423-005-0581-4[Crossref]
• [2] Bani-Hani KE, Gharaibeh KA, Yaghan RJ., Retained surgical sponges (gossypiboma)., Asian J Surg, 2005, 28, 109–115 [Crossref]
• [3] Rajagopal A, Martin J., Gossypiboma-“a surgeon’s legacy”: report of a case and review of the literature., Dis Colon Rectum, 2002, 45, 119–120 http://dx.doi.org/10.1007/s10350-004-6124-1[Crossref]
• [4] Sheehan RE, Sheppard MN, Hansell DM., Retained intrathoracic surgical swab: CT appearances., J Thorac Imaging, 2000, 15, 61–64 http://dx.doi.org/10.1097/00005382-200001000-00012[Crossref]
• [5] Mathew JM, Rajshekhar V, Chandy MJ., MRI features of neurosurgical gossypiboma: report of two cases., Neuroradiology, 1996, 38, 468–469 http://dx.doi.org/10.1007/BF00607280[Crossref]
• [6] Kopka L, Fischer U, Gross AJ, Funke M, Oestmann JW, Grabbe E., CT of retained surgical sponges (textilomas): pitfalls in detection and evaluation., J Comput Assist Tomogr, 1996, 20, 919–923 http://dx.doi.org/10.1097/00004728-199611000-00009[Crossref]
• [7] Rappaport W, Haynes K., The retained surgical sponge following intra-abdominal surgery., Arch Surg, 1990, 125, 405–407 [Crossref][PubMed]
• [8] Gawende AA, Studdert DM, Orav EJ, Brennan TA, Zinner MJ., Risk factors for retained instruments and sponges after surgery., N Engl J Med, 2003, 348, 229–235 http://dx.doi.org/10.1056/NEJMsa021721[Crossref]
• [9] Gonzales-Ojeda A, Rodriguez-Alcantar DA, Arenas-Marquaz H., Retained foreign bodies following intraabdominal surgery., Hepatogastroenterology, 1999, 46, 808–812
• [10] Erdil A, Kilciler G, Ates Y, Tuzun A, Gulsen M, Karaeren N, et al., Transgastric Migration of Retained Intraabdominal Surgical Sponge: Gossypiboma in the Bulbus., Intern Med, 2008, 47, 613–615 http://dx.doi.org/10.2169/internalmedicine.47.0391[Crossref][WoS]
• [11] Dhillon JS, Park A., Transmural migration of a retained laparotomy sponge., Am Surg, 2002, 68, 603–605 [PubMed]
• [12] Singh R, Mathur RK, Patidar S, Tapkire R., Gossypiboma: its laparoscopic diagnosis and removal., Surg Laparosc Endosc Percutan Tech, 2004, 14, 304–305 http://dx.doi.org/10.1097/00129689-200410000-00017[Crossref]
• [13] Wan YL, Ko SF, Ng KK, Cheung YC, Lui KW, Wong HF., Role of CT-guided core needle biopsy in the diagnosis of a gossypiboma: case report., Abdom Imaging, 2004, 29, 713–715 http://dx.doi.org/10.1007/s00261-004-0172-9[Crossref]
• [14] Lauwers PR, Van Hee RH., Intraperitoneal gossypibomas: the need to count sponges., World J Surg, 2000, 24, 521–527 http://dx.doi.org/10.1007/s002689910084[Crossref]
• [15] Serra J, Matias-Guiux X, Calabuig R, Garcia P, Sancho FJ, La Calle JP., Surgical gauze pseudotumour., Am J Surg, 1988, 155, 235–237 http://dx.doi.org/10.1016/S0002-9610(88)80702-5[Crossref]

Identifiers

DOI

10.2478/s11536-009-0096-4