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Transmural Migration of Gossypiboma with Intraluminal Small-Bowel Obstruction: A Case Report

João Batista de Sousa, Bruno Augusto Alves Martins, Iulia Anael Rocha Ferreira, Silvana Marques e Silva, Paulo Gonçalves de Oliveira

(Department of Colorectal Surgery, University of Brasília, Brasília, Brazil)

Am J Case Rep 2020; 21:e924506

DOI: 10.12659/AJCR.924506

BACKGROUND: The term “gossypiboma” refers to a textile matrix surrounded by a foreign-body reaction. Gauze, surgical dressings, and sponges are the most frequently retained materials after abdominal surgeries. The incidence is variable and underreported, mostly due to the legal consequences of their discovery, but also because many patients remain asymptomatic. Retained material can penetrate the bowel or bladder, leading to malabsorption, partial or complete bowel obstruction, and gastrointestinal bleeding secondary to vessel erosion.
CASE REPORT: A 26-year-old woman with a 10-month history of abdominal pain and distension presented with intraluminal small-bowel obstruction due to transmural migration of a gossypiboma. Prior to presentation at our service, she had undergone an exploratory laparotomy at another hospital due a locally advanced adenocarcinoma of the rectosigmoid junction.
CONCLUSIONS: Gossypibomas are rare causes of bowel obstruction, but must not be overlooked in the differential diagnosis of patients with a history of laparotomy. Continuous training of medical professionals and strict adherence to proper surgical technique are essential to avoid this problem.

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