New face and…tail of gossypiboma

Abstract

BACKGROUND: Gossypiboma (retained surgical sponge) is a rare but a severe surgical case. It can cause variable and often serious complications requiring repeated and risky surgical interventions in order to remove them, and may lead to high morbidity and mortality. CASE PRESENTATION: We present a case of a gauze pad unintentionally left in the abdominal cavity of a 61-year-old patient after a sigmoidectomy with a Hartmann’s procedure. Although the textile sponge was recognized and removed during the same hospitalization, the patient was subsequently diagnosed with a large abdominal fat-containing mass, requiring repeated surgery. Microscopic examination revealed fibrous-adipose and granulation tissue, and thread granulomas of a foreign body type. CONCLUSIONS: Even relatively short-term retention of a gauze object in the abdominal cavity associated by unusual host response may result in the growth of a large abdominal granuloma, which has all radiological signs of a tumor. To prevent the incidence of gossypiboma, it is necessary to strictly follow the rules of the operating room and apply all the available measures.