Gossypiboma-induced ileal obstruction following cholecystectomy: A case report and literature review

Abstract

Introduction

Gossypiboma, the retention of surgical material in the body post-surgery, is a rare but serious complication often underreported due to legal and reputational concerns. It commonly occurs after abdominal surgeries, with presentations ranging from abscess formation to intestinal obstruction.

Presentation of case

An 18-year-old girl presented with abdominal pain and distention, along with vomiting for six weeks after cholecystectomy. Initial misdiagnoses as pancreatitis delayed appropriate treatment. Exploratory laparotomy revealed an intra-abdominal gossypiboma, which had transmigrated into the ileum, causing obstruction. Surgical removal of the retained pack and ileal resection with primary anastomosis were performed, leading to a successful recovery.

Discussion

The incidence of gossypiboma varies widely and depends on surgical practices. Transmural migration into the gastrointestinal tract, as seen in this case, is rare and potentially life-threatening. Accurate sponge counts, use of radio-opaque materials, and adherence to safety protocols are crucial preventive measures. Imaging modalities aid diagnosis, but surgical exploration remains definitive in uncertain cases.

Conclusion

This case highlights the critical need for awareness, accurate surgical protocols, and vigilance in postoperative management to prevent and manage gossypibomas. Early recognition and intervention can mitigate complications and improve patient outcomes.