A transmural migration of a gossypiboma in the right colon responsible for a mass which mimicked an abscessed colonic tumor: A case report

INTRODUCTION: Gossypiboma or retained surgical sponge is a rare but serious complication of abdominal surgery. Clinical and radiological polymorphism of gossypiboma makes an accurate preoperative diagnosis difficult. PRESENTATION OF CASE: We report an unusual case of a transmural migration of a gossypiboma in the right colon responsible for a mass which mimicked an abscessed colonic tumor, three years after an open myomectomy. A 40-year-old woman was admitted in emergency with generalized abdominal pain associated with fever. Initially, physical examination revealed an acute localized peritonitis in lower right quadrant. A right pericolic perforated abscess was found. A right hemicolectomy was performed. Surgical specimen dissection revealed an intracolonic surgical sponge. DISCUSSION: Gossypiboma after laparotomy may present with symptoms of acute surgical or chronic abdominal pain. Radiographs are the most commonly used method to detect retained sponges. Surgery is the preferred method of treatment for gossypiboma. CONCLUSION: Episodes of atypical colonic obstruction and nonspecific abdominal pain that have occurred for several years in a patient with a history of multiple abdominal surgery should be suggestive of intra-colonic migration of a gossypiboma. The most important approach to reduce the incidence of gossibypomas is prevention.