Revista do Colégio Brasileiro de Cirurgiões
Print version ISSN 0100-6991
IGLESIAS, Antonio Carlos and SALOMAO, Renato Manganelli. Intra-abdominal gossypiboma: study of 15 cases. Rev. Col. Bras. Cir. [online]. 2007, vol.34, n.2, pp. 105-113. ISSN 0100-6991. http://dx.doi.org/10.1590/S0100-69912007000200008.
BACKGROUND: Inadvertent intra-abdominal retained surgical sponges and instruments remains unsolved problem in spite of prophylactic measurements. We reviewed our experience with fifteen patients who had retained abdominal surgical sponges. METHODS: Medical records from 15 patients with a confirmed diagnosis of gossypiboma after abdominal surgery treated at Gaffré-Guinle University Hospital between January 1987 and January 2007, were retrospectively reviewed. Data from demographic features, operative findings, and outcomes were recorded. RESULTS: There were eleven (73%) females and four males (27%) with a median age of 50 years old. Previous operations were gynecological (40%), gastrointestinal (27%), obstetrical (13%), urological (13%), and oncological (7%). In two cases, previous operations were performed on emergency basis. The interval from the initial operation ranged from one week to 50 months, with median of eight months. The main clinical presentation were pain and abdominal mass, and intestinal obstruction, however one case have remained asymptomatic. The correct diagnosis was suggested in 12 patients; computed tomography demonstrated a more precise image of retained sponge. Surgical removal of the gossypiboma was carried out in all patients, resolving its complications. Post operative complications were observed in four cases, but all were discharged healthfully; no mortality was observed. CONCLUSIONS: In our series, the initial operation during which the surgical sponge and gauze were left behind was gynecological. Risk factor for gossypiboma is observed only in a few cases. Early removal of gossypiboma is necessary to prevent morbidity and mortality related to its presence. Mortality was not observed in this series. Prevention is the best option. This is based in continuous training and strict adherence to regulations to reduce the incidence to a minimum, although human errors cannot be completely abolished.
Keywords : Surgical sponge; Foreign-body reaction [surgery]; Foreign bodies [complications]; Precipitating factors; Laparotomy.