Textilomas of abdominal cavity

Abstract

Introduction: The term “textiloma” denotes a textile foreign body that is retained inside the patient during surgery. Intra-abdominal textilomas are a rear condition, which is reported non-frequently. Their natural evolution is unclear, whereas diagnosis and treatment are difficult and not standardized. Purpose and Objectives: To assess the features o f presentation, reliability of preoperative diagnostic methods, and treatment modalities in patients with textilomas. Materials and methods: During 12-years period three patients with suspicions on retained textile foreign bodies were admitted in the National Center of Emergency Medicine. Males - 2, female - 1, with median age 26.6 years. In the past all patients underwent urgent surgical procedures: for penetrating abdominal wounds (2) and ruptured ectopic gestation (1). Time to readmission after first surgery was 9 days, 8 years, and 60 days, respectively. Examination included routine laboratory tests, abdominal ultrasound, and computed tomography in all cases. Results and discussion; On the basis of imagine studies the diagnosis of intraabdominal postoperative abscess was supposed in two patients, and a gastric tumor - in one. The ultrasound scan features included a well-defined mass with a hypoechoic rim and a strong posterior shadow. Abdominal computed tomography revealed a well-defined “spongiform” mass with gas bubbles inside. All three patients had repeated surgery with removing foreign bodies and drainage of the residual cavity (2 cases), and subtotal gastrectomy en bloc with textiloma (in one). All patients had a complicated postoperative recovery with length of in-hospital stay 50, 39 and 33 days, respectively. Conclusions: The possibility of textiloma should be in the differential diagnosis of any postoperative patient, who presents with signs of peritoneal infection or with abdominal mass. Repeated surgery is required for removing foreign bodies from abdominal cavity. Avoidance of leaving foreign bodies inside the patients could be possible by careful count of surgical materials, and thorough exploration of the surgical site.