Intraperitoneal gossypibomas: the need to count sponges

Abstract

Intraperitoneal forgotten foreign bodies are prone to create adhesions and to encapsulate, or to provoke an exudative response, with or without accompanying bacterial infection. Often a process of self-extrusion is initiated. This is also true for gossypibomas, retained surgical sponges. Presentation is possible as a pseudotumoral, occlusive, or septic syndrome; several cases, however, have remained asymptomatic for as long as several decades. Ultrasonography and radiology (especially computed tomography) contribute significantly to the detection of gossypibomas; magnetic resonance imaging is a less used technique. Detection by plain radiography is difficult. Ultrasonography demonstrates a hyperreflective mass with hypoechoic rim and a strong posterior shadow. Computed tomography shows a well defined mass with internal heterogeneous densities. Therapy consists of operative removal of the foreign body in association with resolving its complications. Adding a series of five cases to the existing literature reports, the fate of intraperitoneal forgotten surgical sponges is reviewed.