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CASE REPORT
Asymptomatic gossypiboma with complete intramural migration and ileoileal fistula
  1. Pranav Mohan Singhal,
  2. Manu Vats,
  3. Sushanto Neogi and
  4. Mehul Agarwal
  1. General Surgery, Maulana Azad Medical College, New Delhi, India
  1. Correspondence to Dr Manu Vats, vatsmanu{at}gmail.com

Abstract

Retained gossypiboma is a rare and under-reported complication of surgery, which can present in a variety of ways. Thus, a very high index of suspicion is required by the clinician to clinch the diagnosis in a postoperative patient. A 45-year-old woman, who was otherwise asymptomatic, presented to the General Surgery outpatient department (OPD) with a contrast-enhanced CT suggestive of a retained intra-abdominal foreign body from previous surgery. An exploratory laparotomy was planned on elective basis. Intraoperatively, dense inter-bowel adhesions were found in the upper abdomen. After a meticulous adhesiolysis, an ileoileal fistula and an intraluminal surgical sponge were discovered. Resection and anastomosis of the involved ileal segment was done. An asymptomatic patient with a migrated intramural gossypiboma with an ileoileal fistula is an extremely rare occurrence. In these circumstances, it becomes almost impossible for the surgeon to clinch the diagnosis of a gossypiboma in an otherwise asymptomatic patient, without the aid of radiological investigations.

  • healthcare improvement and patient safety
  • general surgery
  • gastrointestinal surgery

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Footnotes

  • Contributors PMS and MV conceived the manuscript. PMS prepared the manuscript and provided the images. MV and SN edited the manuscript. SN reviewed the manuscript. MA provided the histopathology report. All the authors read and approved the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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