Gossypiboma a Diagnostic Dilemma or Medical Negligence A Case Report

Authors

  • M K Garg Professor & HOD Department of General & Minimal Invasive Surgery, BPS Govt. Medical College for Women Khanpur Kalan, Sonepat, Haryana, India
  • M T Zeya Assist. Prof, Dept. of Anesthesiology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab
  • Uma Garg Prof. & HOD, Dept. of ENT Adesh Institute of Medical Sciences and Research, Bathinda, Punjab
  • Sunder Goyal Professor Adesh Institute of Medical Sciences and Research, Bathinda, Punjab
  • Mukesh Yadav Prof. & HOD, Dept. of FMT, School of Medical Sciences & Research, Sharda University, Greater Noida, UP

DOI:

https://doi.org/10.48165/

Keywords:

Gossypiboma, Sponge, Retained foreign body, Textiloma, Boma, Textilis

Abstract

 Gossypiboma or textiloma is a rare avoidable surgical disaster which has got medicolegal  repercussions. It is a mass lesion due to a retained surgical cotton sponge surrounded by foreign-body  reaction. The aim of this study was to review the literature on forgotten sponges to identify incidence, risk  factors, mechanism of intraluminal migration and preoperative diagnostic modalities. A 50-year-old lady  presented with palpable abdominal mass seventeen years after appendicectomy. A clinical diagnosis of  mesenteric cyst was made. Ultrasound revealed a heterogeneous mass with variable echogenicity. On  laparotomy, retained foreign body (cotton sponge) was found. Retained foreign body (RFB) should  always be considered in the differential diagnosis of any postoperative patient who presents with pain,  infection, or palpable mass or with unusual symptoms. Doctrine of ‘Res Ipsa Loquitur’ along with ‘discovery rule’ may be applied in some cases,  depending on whether fact brought to the notice of the patient or relatives and grievance of patient with  the doctor or hospital as the case may be. Since these facts comes to notice after a long gape, cause and  effect relationships is very difficult to prove.  

Downloads

Download data is not yet available.

References

Jamjoom F.Z, Kallukaran F. Gossypiboma following mandible surgery: a case report and review of the literature. Oral Surgery 2013; 6: 94-97.

Lata I, Deepa Kapoor D, Sahu S. Gossypiboma, a rare cause of acute abdomen: A case report and review of literature. IJCIIS 201; 1(2): 157-160

Gibbs VC, Coakley FD, Reines HD. Preventable errors in the operating room: retained foreign bodies after surgery. Curr Probl Surg. 2007; 44: 281–337.

Kiernan F, Joyce M, Byrnes CK, O'Grady H, Keane FB, Neary P. "Gossypiboma: a case report and review of the literature". Ir J Med Sci 177 (4): 389–391.

Manzella A, Filho PB, Albuquerque E, Farias F, Kaercher J. “Imaging of gossypibomas: pictorial review".AJR Am J Roentgenol 2009; 193 (6 Suppl): S94–101.

Kim HS, Chung TS, Suh SH, Kim SY. "MR imaging findings of paravertebral gossypiboma". AJNR 2007, Am J Neuroradiol 28 (4): 709–713.

Malhotra MK. Migratory Surgical Gossypiboma-Cause of Iatrogenic Perforation: Case Report with Review of Literature. Nigerian J Surgery 2012; 18:1.

Nizamuddin S. “Gossypiboma” an operative team’s dilemma. Pakistan J Surg 2008; 24:159-162.

Risher W H, McKinnon WMP. Foreign body in the gastro intestinal tract: intra luminal migration of a laparotomy sponge. South Med J 1991; 84: 1042-1045.

Gawande AA, Studdert DM, Orav EJ, Brennan TA, Zinner MJ. Risk factors for retained instruments and sponges after surgery. N Engl J Med. 2003; 348: 229–235.

Fabian CE. Electronic tagging of surgical sponges to prevent their accidental retention. Surgery. 2005; 137: 298–301.

Cruz RJ, Jr, Poli de Figueiredo LF, Guerra L. Intra-colonic obstruction induced by a retained surgical sponge after trauma laparotomy. J Trauma. 2003; 55: 989–991.

Chau WK, Lai KH, Lo KJ. Sonographic findings of intra-abdominal foreign bodies due to retained gauze. Gastrointest Radiol 1984; 9: 61-63.

Shyung LR, Chang WH, Lin SC, Shih SC, Kao CR, Chou SY. Report of gossypiboma from the standpoint in medicine and law. World J Gastroenterol 2005; 11: 1248-1249.

Gencosmanoglu R, Inceoglu R. An unusual cause of small bowel obstruction: Gossypiboma – case report BMC Surgery 2003; 3. 16. Cekirge S. Weiss J P, Foster R G, Neiman H L, Mclean G K. Percutaneous retrieval of foreign bodies: experience with the nitinol goose neck snare. J Vasc Interv Radiol 1993; 4: 805-810. 17. Recommended practices for sponge, sharp, and instrument counts. AORN Recommended Practices Committee. Association of peri Operative Registered Nurses". AORN J 70 (6): 1083–1089. December 1999.

Gibbs VC, Coakley FD, Reines HD. "Preventable errors in the operating room: retained foreign bodies after surgery--Part I". Curr Probl Surg 2007; 44: 281–337

Macario A, Morris D, Morris S. Initial clinical evaluation of a handheld device for detecting retained surgical gauze sponges using radiofrequency identification technology. Arch Surg. 2006; 141: 659–662.

Pushpabhai Purshottam Udeshi & Ors. vs. M/s Ranjit Ginning & Pressing Co. (P) Ltd. & Anr., (1977) 2 SCC 745.

Salmond on the Law of Torts (15th Ed.) at p. 306.

Halsbury's Laws of England, 3rd Ed., Vol. 28, at page 77. 23. Vipin Sanghi, J. Harinder Kaur vs. Add. District and Sessions Judge and Ors., W.P.(C)14129/2009, DATE of Judgment: 04.05.2012, http://lobis.nic.in/dhc/VS/judgement/07-07-

/VS04052012CW141292009.pdf

Published

2014-04-30

How to Cite

Garg, M. K., Zeya, M. T., Garg, U., Goyal, S., & Yadav , M. (2014). Gossypiboma a Diagnostic Dilemma or Medical Negligence A Case Report . Journal of Indian Academy of Forensic Medicine, 36(1), 100-103. https://doi.org/10.48165/