Gossypiboma Complicating Conservative Treatment of Post-Operative Fistula and a Proposed Classification System
Published: 2022-09-22
Page: 305-309
Issue: 2022 - Volume 5 [Issue 2]
Aremu Isiaka *
Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Agodirin Olayide
Department of Surgery, University of Ilorin, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Olatoke Samuel
Department of Surgery, University of Ilorin, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Aremu Latifat
Department of Radiology, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Gossypiboma denotes surgically retained cotton or sponge following intra-abdominal procedures. The incidence of gossypiboma as a cause of small bowel obstruction still remains very low, probably due to under reporting.
Presentation of Case: A case report of a 45 yr old female with mechanical small bowel obstruction from gossypiboma. She had exploratory laparotomy with extraction of three pieces of rolled up gauzes.
Discussion: The theory for intraluminal gossypiboma is the suppurative inflammation and necrosis with transmigration of the retained intra-abdominal gauze through a spontaneous enteric fistulation. We propose a possible alternative theory; the migration of sponge into bowel lumen through an iatrogenic fistulous tract following conservative treatment of enterocutaneous fistula and a possible classification of gossypiboma into (intra-operative and post-operative) base on timing of occurrence.
Conclusion: In recognition of post-operative gossypiboma, management of enterocutaneous fistulas should be considered an extended continuation of intra-abdominal procedures.
Keywords: Gossypiboma, small bowel obstruction, post-operative fistula