Presenting Author –

Dr. Amit Kharat

Co-Authors –
Dr. Dhaval K. Thakkar

Institution –
Dr. D. Y. Patil Medical College,
Pimpri, Pune
 Clinical Profile:
23 years/female came with c/o severe pain in abdomen and PV bleeding
She was operated 11 days ago for suspected ruptured ectopic pregnancy for
which exploratory laprotomy was done.
Presently - Patient complained of having vague pain in abdomen since 2-3 days.

Figure 1 : Sonogram which shows inhomogeneous mass in right lower abdomen

with peripheral echogenic margins and reverberations.
Radio-opaque foreign body (in form of gauze piece with surgical thread ) is seen right
hypogastric region. Appearance is consistent with retained foreign body (in form of
gauze piece with surgical thread sutures)
Plain - CT Abdomen – going from cranial to caudal direction. Evidence of 10.0cm (CC) x
9.91 cm(Trans) x 6.75cm (AP) heterogeneously hypodense mass having spongiform
appearance with gas bubbles with few hyperdense strands is noted in RIF region. So
considering recent history of surgery, it is mostly likely to be gossypiboma.
Mini-laparotomy revealed surgical specimen gossypiboma
(grasped by the clamp)
 GOSSYPIBOMA

 A surgical sponge is the most common Differential diagnosis

type of retained foreign body (RFB). Abdomen
 The condition is sometimes called 1. Abscess: CT findings of gossypiboma may
gossypiboma, derived from the Latin be indistinguishable from those of an
gossypium (cotton) and the Swahili boma intraabdominal abscess.
(place of concealment). 2. Intestinal obstruction: Although
 Frequent sites of gossypiboma formation gossypiboma is rarely seen in daily clinical
include: practice, it should be considered in the
1. Intrathoracic differential diagnosis of acute mechanical
a. pleural cavity intestinal obstruction in patients who
b. pericardial cavities previously underwent laparotomy
2. Abdominal cavity
 GOSSYPIBOMA

Take Home Message

The diagnosis of a GOSSYPIBOMA is not often easy, and delayed diagnosis can be
problematic. Awareness of the typical radiologic appearances is critical to the
diagnosis of retained surgical sponges or swabs. Inadvertently retained sponges are
often clinically unsuspected and may be first recognized on imaging. Retained
Foreign Body should be considered in the differential diagnosis of any
postoperative patient who presents with pain, infection, or palpable mass
 GOSSYPIBOMA

REFERENCES

1. Kim CK, Park BK, Ha H. Gossypiboma in abdomen and pelvis: MRI findings in four patients. AJR Am J
Roentgenol. 2007;189 (4): 814-7.
2. Murphy CF, Stunell H, Torreggiani WC. Diagnosis of gossypiboma of the abdomen and pelvis. AJR Am J
Roentgenol. 2008;190 (6): W382.
3. Lo CP, Hsu CC, Chang TH. Gossypiboma of the leg: MR imaging characteristics. A case report. Korean J
Radiol. 4 (3): 191-3.
4. Haaga JR, Boll D. CT and MRI of the whole body. Mosby. (2009) ISBN:0323053750.
5. Manzella A, Filho PB, Albuquerque E et-al. Imaging of gossypibomas: pictorial review. AJR Am J
Roentgenol. 2009;193 (6_supplement): S94-101.