Gossypiboma Masquerading as Calcified Mesenteric Cyst a Case Report

Retained textile material following surgery (Gossypiboma) occurs rarely, though it causes significant morbidity and mortality. It is usually under-reported for fear of litigation. The clinical course could be subacute or chronic with difficult diagnosis due to non-specific symptoms and inconclusive radiological imaging findings. This report is that of a 55year-old female who presented 91 months after total abdominal hysterectomy and bilateral salpingo-oophorectomy with an asymptomatic abdominal mass in the umbilical and suprapubic regions. An abdominal computed tomographic scan suggested a calcified mesenteric cyst. However, exploratory laparotomy revealed an abscess cavity with an embedded abdominal mop densely adherent to the small bowel and walled off by omentum. The mop was removed with resection and anastomosis of adherent bowel loops and drainage of the abscess. The postoperative period was uneventful and the patient is doing well after discharge. The diagnosis of gossypiboma should be considered in patients with non-specific symptoms following abdominal surgery. Prompt radiological imaging of the abdomen and a high index of suspicion in such patients could enhance early diagnosis and intervention resulting in reduced morbidity and mortality. Prevention of its occurrence is of utmost importance, with particular attention to thorough swab counts before and during operative procedures.