Computed tomography findings of abdominal textiloma

Abstract

Background. The unintentional leaving of gauze sponges in the abdomen after laparotomy is a rare but serious medical error. The diagnosis of a textile foreign body can be challenging due to its rarity, potential long-term asymptomatic evolution, and nonspecific imaging findings that may be unfamiliar to radiologists. Materials and methods. The data of 13 radiologically identified and surgically confirmed cases of abdominal textilomas treated over a 15-year period were assessed retrospectively. There were 10 women (76.9%) and 3 men (23.1%); the average age was 38.5±4.7 years. The average interval between the previous procedure and the diagnosis of textiloma was 25.3±15.2 months, ranging from 1 day to 16 years. Results. The most common imaging patterns seen on CT included masses with a typical spongiform structure with numerous small air bubbles and surrounded by a thin capsule, as well as a high-density, well-circumscribed lesion, sometimes with mottled calcification, and a dense capsule with intense contrast accumulation. Based on surgical history, physical examination, and CT scan findings, a likely diagnosis of textiloma was made before surgery in 11 (84.6%). In all patients, a repeated open surgery was necessary to remove textile foreign bodies. Conclusions. The possibility of an abdominal textiloma should be considered in the differential diagnosis of any postoperative patient who presents with pain, infection, or a palpable mass. CT scanning is a practical and highly sensitive diagnostic tool for detecting textilomas with characteristic imaging features in both chronic encapsulated and acute inflammatory manifestations.