Lower gastrointestinal bleeding due to colonic fistula caused by a gossypiboma: Case report and literature review.
Colonic fistula
Complication
Foreing body
Gossypiboma
Lower gastrointestinal bleeding
Retained surgical item
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
2020
2020
Historique:
received:
04
04
2020
revised:
15
05
2020
accepted:
16
05
2020
pubmed:
9
6
2020
medline:
9
6
2020
entrez:
8
6
2020
Statut:
ppublish
Résumé
Even in modern surgery, human mistakes cannot be totally avoided. Retained surgical items are among the most feared ones. Forgotten sponges inside patients can cause a wide range of complications due to the foreign body reaction, called gossypiboma. The incidence of gossypibomas in the literature is probably underreported due to its legal implications; however, we must know its consequences and highlight the importance of the prevention strategies. We present a case where only preventive measures would have avoided its fatal outcome. An 85-year-old male, previous left nephrectomy 12 years before, came to the emergency room with hematochezia and hemodynamic instability. An emergent angio-CT revealed a 12 cm mass due to a gossypiboma near the descending colon; the presence of air suggested an infection and/or fistulization to the bowel. It was decided not to perform invasive procedures, resulting in the patient's death. Gossypibomas can remain asymptomatic for years, being diagnosed when causing an obstruction, malabsorption, septic symptoms or even spontaneously. This may lead to high morbidity and mortality rates. In order to prevent it, different strategies have been described, with the objective to intensify surveillance. When diagnosed, laparotomy, laparoscopic and even endoscopic procedures have been performed successfully. We suggest putting all our efforts in identifying high risk patients and surgeries, training the OR team and enhancing protocols and checklists to minimize any preventable errors.
Identifiants
pubmed: 32506032
pii: S2210-2612(20)30354-0
doi: 10.1016/j.ijscr.2020.05.053
pmc: PMC7283079
pii:
doi:
Types de publication
Case Reports
Langues
eng
Pagination
59-62Informations de copyright
Copyright © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare no conflict of interest.
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