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Case Reports
. 2014 Jan 8:2014:bcr2013201814.
doi: 10.1136/bcr-2013-201814.

Intrathoracic gossypiboma

Aamir Hameed  1 , Ayesha Naeem, Maimoona Azhar, Saulat Husnain Fatimi
Affiliations
Case Reports

Intrathoracic gossypiboma

Aamir Hameed et al. BMJ Case Rep. .

Abstract

Gossypiboma refers to retained sponge or swab in any body cavity after surgery. Although it is a rare occurence, it can lead to various complications which include adhesions, abscess formation and subsequent infections. Gossypiboma occurs as a result of not using radio-opaque sponges, poorly performed sponge counts, inadequate wound explorations on suspicion and misread intraoperative radiographs. Therefore, this event can be avoided if strict preventive measures are taken. Moreover, further complications can be avoided following the correct and early diagnosis of gossypiboma. Gossypiboma is an important topic as it carries great medicolegal consequences for the surgeon. We have presented three cases of intrathoracic gossipiboma following previous cardiothoracic surgeries. They presented years after their surgeries, with features varying from patient to patient, ranging from cough and fever to no sypmtoms at all. CT scan only showed a mass lesion in all cases, therefore we proceeded for CT-guided biopsy which was also found to be inconclusive. It was only after entering the thoracic cavity via video-assisted thoracoscopy/thoracotomy that the diagnosis was made and sponges were taken out successfully. All our cases recovered with no further complications.

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Figures

Figure 1
Figure 1
(A) Chest CT showing >5 cm mass involving the anterior and middle mediastinum. (B) Right-sided thoracotomy: white arrow show the retained sponge which appeared to be a mass lesion in anterior and middle mediastinum on radiology. (C) Recovered swab threads.
Figure 2
Figure 2
Chest CT: red arrow showing mass in the oblique fissure of the left upper lobe.
Figure 3
Figure 3
(A) Chest X-ray: red arrow show mass lesion adjacent to the right border of heart. (B) CT of chest: red arrow show cystic mass lesion suggestive of thymoma/mesothelial cyst. (C) Right-sided thoracotomy: per operative appearance of cystic wall of mass lesion. (D) Right-sided thoracotomy: per operative picture of retrieval of retained fibres of swab/lap pad from thoracic cavity.
See this image and copyright information in PMC

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