Multiple Gossypibomas Resulting in Intra-Abdominal Abscess and Intestinal Fistula after Caesarean Section: a Case Report

Background: Gossypiboma is a term for a surgical complications resulting from foreign materials, such as a surgical sponge, accidentally left inside a patient's body. Methods: We report a rare case of woman who presented with multiple gossypibomas resulting in intra-abdominal abscess and intestinal fistula after caesarean section. Results: A 35-year-old Chinese woman was referred to our hospital for abdominal pain of three months, diarrhea of one month and melena of one week. Three months ago, she had once undergone caesarean section at a county hospital. The abdominal computed tomography revealed two mass-like enhancement in right iliac fossa and left iliac fossa. Therefore, a laparotomy was performed. An operation including removal of intraabdominal foreign object, abdominal abscess drainage, partial enterectomy, partial sigmoid colon resection and descending colostomy were performed. The operation revealed that two gossypibomas in the abdomen led to intra-abdominal abscess and intestinal fistula. Conclusion: Gossypiboma, although it's a rare postoperative complication, should be taken into consideration in the diagnosis of abdominal mass, especially in the patients who has undergone abdomenal operations. Sub headings: Gossypibomas resulting in intra-abdominal abscess and fistula Gossypiboma (cottonoid or textiloma1) is a term used to describe a foreign object, such as a mass of cotton matrix or a sponge, which is accidentally left in a body cavity during an operation [1]. It is an unacceptable and entirely preventable surgical complication. Open surgery and laparoscopic surgery are the common approach in the treatment of gossypiboma. However, endoscopy can also be feasible for both diagnosis and treatment of gossypiboma [2-6]. We report a case of multiple gossypibomas resulting in intra-abdominal abscess and intestinal fistula after caesarean operation, which was successfully treated by open operation. 1. CASE PRESENTATION A 35-year-old Chinese woman was referred to our hospital for abdominal pain of three months, diarrhea of one month and melena of one week. Three months ago, she underwent caesarean section atacounty hospital. After operation, she always hadintermittent lower abdominal dull pain and distension, but had no history ofnausea, vomiting, poor appetite orbody weight loss. She once went to Guiyang Obstetric and Gynecology Hospital and The Third Guizhou Provincial People’s Hospital, receivedanti-inflammatory treatment, she feeled the abdominal pain relieved to some extent. One