Gossypiboma- A Rare Cause of Gastric Outlet Obstruction-Advanced Research in Gastroenterology & Hepatology-Juniper Publishers

JUNIPER PUBLISHERS-Advanced Research in Gastroenterology & Hepatology




GOSSYPIBOMA- A RARE CAUSE OF GASTRIC OUTLET OBSTRUCTION

Authored by Parveen Malhotra

Introduction: Gossypiboma is a surgical instrument or sponge left inside patient’s body post operatively. It has varied manifestations from being asymptomatic to severe complications like vomiting, pain abdomen, obstruction, perforation, peritonitis and even death. Rarely it can have transmural migration and leads to bowel or visceral perforation, obstruction or fistula formation which usually occurs in stomach, ileum or colon. Very few cases have been reported in literature till now. We report the largest transmural migrated gossypiboma to date which was a surgical mop measuring 26 × 23 cm and was successfully removed endoscopically.
Our Case: A fifty eight year-old man who was symptomatic for gallstones underwent open cholecystectomy six months back at some private hospital. He was asymptomatic for one month post-operatively but later on developed pain abdomen, dyspepsia, anorexia and intermittent vomiting. On investigating, barium swallow and abdominal ultrasonogram revealed a filling defect at antrum of stomach and duodenum which gave suspicion of malignancy. On upper gastrointestinal endoscopy, a surgical mop that had totally migrated into the stomach and duodenum was seen. The surgical mop was successfully removed by endoscopy and patient recovered completely after the procedure.
Conclusion: Gossypiboma should not be missed in any postoperative patient with unexplained pain abdomen and vomiting. Endoscopy is both diagnostic as well as therapeutic modality but surgery becomes definitive treatment in endoscopically failed cases or when incomplete migration of gossypiboma occurs into the stomach.


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